Michigan HB 5126: Endangering children by making nonmedical vaccine exemptions easier to obtain

We have a problem with antivaccinationists here in Michigan. It’s a problem that’s been going on a long time that I first started paying attention to in a big way a few years ago when we started seeing pertussis outbreaks again due to low vaccine uptake. It’s a problem that’s persisted as last year we suffered from outbreaks of pertussis and measles, again because of pockets of low vaccine uptake. And what is the reason for these pockets of low vaccine uptake? Well, consistent with what we already know, namely that the risk of pertussis outbreaks is elevated in states where exemptions to school vaccine mandates are easier to get, it’s because our state is one of the worst in the country when it comes to nonmedical exemptions to vaccines. Indeed:

Michigan has one of the highest vaccine-waiver rates for kindergartners in the country, three times the national median, according to the Centers for Disease Control and Prevention. And the number of kindergartners getting vaccine waivers is growing. In five years, it’s increased 23 percent, the CDC says.

As a result, last year the Michigan Department of Community Health altered the rules for obtaining philosophical or religious exemptions from school vaccine mandates. Beginning January 1, 2015, the state started requiring that parents seeking a nonmedical exemption to school vaccine mandates for their child were required to:

Be educated by a local health worker about vaccines and the diseases they are intended to prevent.

Sign the universal state form that includes a statement of acknowledgement that parents understand they may be putting their own children and others at risk by refusing the shots.

Before, all it took was to sign a waiver form, and parents didn’t even necessarily have to use the state form. Now they have to go to the health department in person and receive counseling about vaccines. Basically, this rule change was something that was long overdue, given what a joke Michigan’s rules governing school vaccine mandates had become. It was a rule chance that really pissed off the state’s antivaccine movement, leading some to claim that the health department had broken the law. It hadn’t, as the rules were approved by the Joint Committee on Administrative Rules.

Given how thoroughly our state legislature has been taken over by Tea Party conservatives of the ilk who are very susceptible to the antivaccinedog whistle that misrepresents school vaccine mandates as an unacceptable infringement on personal liberty or even incipient fascism (my very own state senator is one of them), I suppose I shouldn’t be surprised that after less than a year it’s already trying to reverse course. I learned this over the weekend when an e-mail was forwarded to me, which I’ll reprint in full:

Parent Voices Needed to Share the Importance of Immunizations

Immunizations once nearly eradicated many diseases from our population, but they’re making a dangerous comeback. In 2014, Michigan had a drop of 5% in the number of children immunized and we now rank 47th in the nation. Michigan has the sixth highest rate of non-medical immunization waivers for kindergarten entry—meaning we have many children entering school who are not immunized.

Two bills introduced this week in the state Legislature would curtail efforts to improve Michigan’s childhood immunization rate and further endanger our most vulnerable citizens. House Bills 5126 and 5127 would eliminate the rule requiring parents seeking non-medical waivers to receive balanced education about the benefits and risks of immunizations from their local public health department. The bills also would strip a local public health department’s ability to exclude children with a communicable disease or those who lack vaccine protection, from attending school during an outbreak.

In light of this new legislation, and ongoing misinformation campaigns from anti-vaccination groups, we are seeking individuals who can speak to how vaccines benefit them and their family. Maybe you have been touched by vaccine-preventable disease or you have an infant too young to be fully immunized. Maybe you have an immunocompromised child or older adult in your life who you want to protect. Maybe you work in the medical field with pediatric cancer or organ transplant patients who cannot be fully immunized for medical reasons. Whatever the reason you feel connected to the issue of vaccination, we want to enlist your help in our efforts to ensure public policy and public opinion reflect the need for strong immunization rates. While we will always provide clear, science-based information about vaccines and vaccine-preventable diseases, we need you to share your real-life examples about how vaccines save lives.

Opportunities to speak could include providing testimony to legislative committees, talking with the press or meeting with individual legislators to talk about your story. We would assist you in crafting your message and arranging these meetings.

If you are willing to be part of this vaccine positive network, or would like to learn more, please send an e-mail to Bree Anderson at [email protected] at the Michigan Council for Maternal and Child Health. MCMCH is part of a group of statewide advocacy organizations working together proactively on legislation and policy to improve immunization rates in Michigan.

I think I very well might have to be in touch with Ms. Anderson, and if you’re in the state of Michigan I’d encourage you to get in touch as well. In the meantime, let’s take a look at these bills (House Bill 5126 and 5127), which are now being considered by the Michigan House Committee on Health Policy. In HB 5126, the money quote is here:

(2) A child is exempt from this part if a parent, guardian, or person in loco parentis of the child presents a written statement to the administrator of the child’s school or operator of the group program to the effect that the requirements of this part cannot be met because of religious convictions or other objection to immunization.

(3) THE DEPARTMENT’S AUTHORITY TO PROMULGATE RULES UNDER SECTION 9227 DOES NOT INCLUDE THE AUTHORITY TO PROMULGATE OR ENFORCE A RULE THAT IMPOSES A DIFFERENT OR ADDITIONAL REQUIREMENT FOR A CHILD TO BE EXEMPT FROM THIS PART THAN THOSE DESCRIBED IN THIS SECTION OR THAT REQUIRES THE EXEMPTIONS DESCRIBED IN THIS SECTION TO BE ON A FORM PRESCRIBED BY THE DEPARTMENT.

(4) IF THE DEPARTMENT PROVIDES INFORMATION TO THE PUBLIC ON THE EXEMPTIONS DESCRIBED IN THIS SECTION, THEN WITH THAT INFORMATION THE DEPARTMENT SHALL INCLUDE INFORMATION ABOUT THE EFFECTIVENESS AND POTENTIAL RISKS OF IMMUNIZATION FOR DISEASES ABOUT WHICH THE DEPARTMENT REQUIRES IMMUNIZATION UNDER SECTION 9227.

In other words, this bill is designed specifically, among other things, to reverse the rule change that now requires parents seeking nonmedical exemptions to school vaccine mandates to undergo counseling by a medical professional on the benefits and risks of vaccines and, in particular, the risks of not vaccinating. It gets worse, though:

(2) THE DEPARTMENT’S AUTHORITY TO PROMULGATE RULES UNDER SECTION 5111 DOES NOT INCLUDE THE AUTHORITY TO PROMULGATE OR ENFORCE A RULE ALLOWING A LOCAL HEALTH OFFICER WHO CONFIRMS OR REASONABLY SUSPECTS THAT AN INDIVIDUAL ATTENDING A SCHOOL OR GROUP PROGRAM HAS A COMMUNICABLE DISEASE TO, AS A DISEASE CONTROL MEASURE THAT IS NOT IN THE CASE OF AN EPIDEMIC, EXCLUDE FROM ATTENDANCE AN INDIVIDUAL WHO LACKS DOCUMENTATION OF IMMUNITY OR IS OTHERWISE CONSIDERED SUSCEPTIBLE TO THE COMMUNICABLE DISEASE. AS USED IN THIS SUBSECTION, “GROUP PROGRAM” MEANS THAT TERM AS DESCRIBED IN SECTION 9211.

Yes, you read that right. HB 5126 specifically eliminates the authority of the Michigan Department of Community Health to make or enforce a rule that allows a local health official to exclude a child who lacks documentation of immunity from school when a child in that school has a communicable disease. So basically, if this law passed, not only would it take us back to the ridiculously easy process for parents to obtain nonmedical exemptions but it would also make it nearly impossible for local health officers to keep unvaccinated children out of school during an outbreak and, given the wording, might even hinder their ability to keep children with a communicable disease out of school. (The wording to me is a bit ambiguous about that.) The stupid, it burns. It boggles the mind. It’s unbelievable. Except that it’s not. Believe me, our state legislature right here in Michigan really is that dumb and dysfunctional. I thought it was bad in New Jersey when I lived there, but New Jersey’s got nothing on Michigan.

Concerned parents came in droves to the state capital Wednesday morning to protest a new vaccine waiver policy which opponents say bullies parents.

But supporters say the new policy, which requires parents to make an appointment with the county health department to officially obtain a waiver, is working. Although some counties had already been doing this, it’s a big change for parents who had previously been able to waive their child’s vaccinations with a quick signature in a school’s office.

Of course, another thing that antivaccine activists don’t like is that the rule change is working. According to the news article, last year the waiver rate was 5%. This year, although the figures are preliminary, the waiver rate is on track to be 1%. If that number holds up over the next couple of years, it would be powerful evidence that the new rule, at least on preliminary examination, appears to be working to accomplish its intended purpose: To reduce the percentage of students whose parents claim nonmedical exemptions to school vaccine mandates. Such a change can only help our state’s abysmal record.

I suppose I shouldn’t be surprised. Whenever I think the Michigan legislature can’t sink any lower, inevitably it proves me wrong. This time around, in the name of “freedumb,” it’s willing to consider throwing the children of Michigan under the bus because some entitled parents are inconvenienced because they have to go to the county health office to claim a nonmedical exemption based on their pseudoscientific beliefs for their special snowflake. We can only hope that sanity prevails in the House health committee and these misbegotten bills are shot down before they go anywhere. I’m not optimistic.

@ Todd W.: that’s what amazed me, also. I can’t believe they actually are prohibiting quarantine measures. I realize they believe that their special snowflake could NEVER be the cause of an outbreak, and, of course, since they only do organic foods and have healthy children, they won’t get sick or have nay complications.

If I was in Michigan, believe me I’d be at the capital, protesting. This is ridiculous.

Rep. Hooker (what is it with people that have the surname “Hooker”?) is apparently of the opinion that government agencies should be prohibited from doing the jobs with which they’re charged. I propose we submit legislation that would prohibit Rep. Hooker from sponsoring, drafting, submitting, or voting on any legislation. And if he speaks, he must include information about the risks of listening to him.

In the 1970’s, I remember the presence of one part-time nurse in our elementary school of about 500 kids.

We also recited the Pledge of Allegiance of the United States each morning.

Would it have been better to use that time to check our body temperature for a fever?

Here’s my point, there may be additional ways to support “health & wellness” for school children.

In an effort to help maintain a healthy school environment in the 21st century, vaccinated/un-vaccinated students could be taught, and encouraged, to create a personal body-temperature profile each school day.

This real-time medical information could be used to reduce the spread of infectious disease.

Perhaps the rightists/ tea party/ conservatives will soon have another issue to write bills about since a small town in the Detroit area has now elected a Muslim majority city council
( BBC, National Journal)- although the Catholic Mayor didn’t appear to be too worried.

I heard the water in Flint was bad, is it being shipped to the cafeteria in the House of Representatives? Or just what is the qualification need to be elected to that House? Totally insanity and an IQ < 20?

@MJD: I don’t know about you, but I remember the teachers sending kids to the office to be sent home if they were sick, nurse or no nurse, and parents *did* keep infectious children home. The temperature chart wouldn’t necessarily help – please remember that a lot of viral infections are communicable before you have symptoms.

The Arizona (where i live) State Legislature is truly bad, but even they have not proposed removing quarantine measures from state statutes. However if this effort succeeds in Michigan, I wouldn’t be surprised if they were next in line. I mean after all, Arizona has the Goldwater Institute which spearheads “right to try” legislation.

I would like to think that the parents who do vaccinate in Michigan will be up in arms over this proposed legislation and will speak up and out accordingly.

Just checked the link to Rep. Hooker’s webpage. My nieces who graduated from Grand Valley State must be horribly ashamed that an alumni could be that dense. This man was a teacher and taught health and phys ed for heaven’s sakes!

I plan on emailing his office when I get home from work. And I’ll make sure my family in that area knows what a poor representative he is, since they vote Republican – normally. My family is NOT into woo, thankfully, and believes in vaccines, even the needle-phobic members.

Love how people like to skew the numbers. We really shouldn’t be surprised didn’t report the actual facts instead your biased feelings. Do your readers know that waiving 1 vaccine that may have caused seizures or encephalitis still is falls into your 5 % drop in waiver rates? That those reported rates are whether you waive 1 or all?

Maybe you should have joined in on one of the Health Departments Educational Sessions. So you are ok with them completely and blatantly lying to constituents? Even going against main stream doctors and telling you what your doctor told you is not true? Or how about telling you your reason for exemption isn’t allowed according to Michigan Law when you’ve got the very statue with you? Having to rip up your waiver and refusing to sign it because they wouldn’t put what your stated reason for exemption on your waiver?
If they had truly been an educational session it would have also included the covered risks that are mention in the pages of documentation that comes with each vaccine. Yet no mention of side effects.

And you need to do better research. That group that you keep bashing? Are not anti anything. Most have selectively vaccinated their kids based on research with their doctors. Obviously with our Vaccine Court paying out 3.18 billion dollars in claims for vaccine injuries, there is reason to pause and educate yourselves.

Correction: no one is asking for sick children to be allowed in school. Currently, HEALTHY children are being excluded if another child has the chicken pox (for example). It takes 2 doses of the vaccine to be effective according to the CDC, but you are not excluded if you have had only one dose.
And the pertussis outbreaks you refer to have been related to vaccine failure, occurring in those who have received the vaccine.
All the information is available at the CDC websites. Please take some time to investigate before reporting and trying to instill fear in people!

@Dr Hickie: don’t you just love how they pull out the amounts the Vaccine Court paid without stating how few cases that actually represents compared to the numbers of vaccines given? 3.18 billion sounds like a lot of money. But then you find out it represents only a few thousand cases over 20+ years, with millions of vaccine doses given ANNUALLY, it’s really a very small number.

And obviously the “Healthy Boys” mom is not well educated as to vaccine risks and benefits.

The drop in waiver numbers cannot be looked at apples to apples. Many who previously turned in waivers each year, were not required to do so this year, the new promulgated administrative rule only applies to pre-school, daycare, kindergarten and 7th grade or if you are new to a district. Therefore, the only parents who got a waiver under the new rules were those in a few grades or new to a district, so that right there would account for a lower number of registered waivers. If they were truly educational sessions, they would give information on risks and benefits. The current way it is being done is very on e-sided and amounts in some cases to bullying. This is a free country, parental rights and freedom to chose medical treatments should not be infringed upon, regardless if you are pro or anti vaccine. It is all about freedom of choice and our rights over our body. You think allowing rights to be taken away from a group that you don’t agree with is a good idea, just wait, something that affects you will be next.

Sigh. My guess is that “Raising Healthy Boys” doesn’t like being forced to listen to science-based information that refutes the misinformation that she believes about vaccines. As for “that group,” I presume you’re referring to the NVIC. If that’s the case, I can’t help but let out a hearty chuckle at your claim that the NVIC is not antivaccine. It’s antivaccine to the core.

Christopher Hicks and MI Dawn. Thanks for your kind words! Your obviously have no care or concern about those of us who almost lost a child to a vaccine injury. Go ahead and keep lying to yourselves that it doesn’t happen. Believe me, we became educated very quickly. Too bad VAERS only receives approximately 5% of the actual adverse reactions to the toxins in them.

Of course you wouldn’t respond to the accountability the Health Department should have while educating parents. You really don’t want parents educated.

This is a free country, parental rights and freedom to chose medical treatments should not be infringed upon, regardless if you are pro or anti vaccine. It is all about freedom of choice and our rights over our body.

No one is taking your right away to make a bad choice: your unvaccinated children should just not be allowed to infect others.

Your obviously have no care or concern about those of us who almost lost a child to a vaccine injury.

And I could say the same to you regarding those of us who have lost people or seen them maimed by vaccine-preventable illnesses prior to the vaccine being standard of care, or due the immunosuppression forcing them to rely on those around them because for two weeks every month, their total WBC count is <.50. And we KNOW that was the actual reason, unlike certain groups who like to blame every short straw drawn somehow ON TEH VACCINEZ even if more likely than not entirely unrelated.

All this focus on the children, what about the adults? How can we possibly maintain herd immunity when the majority of adults have not been up to date with the 69 recommend doses of vaccines? How can we be safe going to work or the grocery store if so many people are irresponsible and putting our lives at risk!?
It’s not up to the children to protect us….we all need to go get ALL our shots now! Well, I already have….have YOU???

This is a free country, parental rights and freedom to chose medical treatments should not be infringed upon, regardless if you are pro or anti vaccine. It is all about freedom of choice and our rights over our body. You think allowing rights to be taken away from a group that you don’t agree with is a good idea, just wait, something that affects you will be next.

Problematic statement aside, nobody is taking anything away. You make a decision, there are consequences.

I choose to drink, I’m not allowed to drive because I’m a risk to others. You choose not to vaccinate your kids, you should not be allowed to leach off others fulfilling their social contract in a public setting because you are a risk to others, namely those who ACTUALLY CAN’T be vaccinated.

@Healthy Boys: so, you reported the injury to VAERS and you have a case in Vaccine Court? Or were you compensated for a true table injury?

I should hope that the health department presents the true facts: vaccines are generally safe, very effective, have some risks and are not always 100% effective. Some people have mild reactions to vaccines (give common, mild reactions). Rarely, people have more severe reactions (give examples). If you experience an adverse reaction to a vaccine, you should report it to VAERS and make sure your physician does also.

I know well vaccines aren’t 100% effective. Neither is getting the disease. My sister has had chicken pox twice. I had mumps and measles. I’m not immune, even with the MMR several times. So I depend on herd immunity to protect me from those diseases. (Yes, I have had titers drawn multiple times and no, I’m not immune).

It’s not up to the children to protect us….we all need to go get ALL our shots now! Well, I already have….have YOU???

For all of the vaccines that are approved for my age, yep. How about you?

I agree with you that adults should be up to date on their vaccinations (e.g., pertussis boosters), especially because some diseases (like pertussis) can be mild in otherwise healthy adults but are quite serious to infants, children and the immunocompromised. Those who are especially susceptible to complications from disease do not have flashing neon signs over their heads alerting you to the fact, so how exactly do you avoid those people while you are infectious? Bear in mind that people are often infectious before they even know they’re sick.

Oh, and Vaccine Mommy: yes, I’m up to date on all my vaccines. Those I need, I get, as I discuss them with my doctor regularly. My children are both fully vaccinated. My parents, my siblings, their children are all fully vaccinated. My ex and his wife are fully vaccinated, as are her children. My friends are all up to date also.

I can’t speak for all adults. I can only speak for my friends and family.

Your obviously have no care or concern about those of us who almost lost a child to a vaccine injury.

No, we do have compassion for those who have suffered real vaccine injuries (hint: autism is not a vaccine injury). If your kids suffered a vaccine injury, then you should be covered by the medical exemptions allowed under state law. If it is a valid vaccine injury, then you should also be eligible for compensation from the Vaccine Injury Compensation Program. And if your kids had a reaction to a vaccine leading to a medical exemption from further immunization with those or similar vaccines, then your child has to rely on everyone else around them getting vaccinated in order to reduce the risk that they’ll be infected, since they would likely be at greater risk of infection otherwise.

So, why do you support measures that would lead to more risk to your child?

I was instantly struck by the insane language that excludes a person with a communicable disease from attending a school (while I agree the actual language is so twisted, the underlying anti-science sentiment is readily visible.)

I am also flabbergasted at the idiocy of people of think their “freedom of choice” is more important than public health. Sure, stick with ignorant thinking that their research on vaccines warrants more pertinent standing than the body of science of vaccine effectiveness. But to expect that the consequence of their choices should be imposed upon the wider public is patently absurd. That is the same as expecting a personal choice to ignore germ theory when running a restaurant would go unchallenged or ignored? Its as dangerous as allowing a farmer to sell raw (unpasteurized) milk directly to the public.

An individual’s fanaticism reaches a limit when it impacts public health. Choices have consequences, its why the rules on drunk driving mete out serious penalties (although sadly, enforcement isn’t always effective at preventing stupidity.)

So, if this passes, sick kids can’t legally be excluded from school. That means any kid that can’t be vaccinated can get a VPD from non-excluded sick kid, and then get sick and/or die. Can the parents sue the parents of the non-excluded sick kid? Could they sue the state for stupid rule-making that set their child up to be killed by a VPD? Geez, these people.

If my guess is correct that this is about a febrile seizure, I would think they would want more people to do things like keep a sick kid home. After all I suspect a higher fever for a longer period of time (as you get from an illness) is a bigger risk that the typically milder fever for less time someone gets from a vaccination.

Maybe fevers are homeopathic and the less you have of them the stronger the effect?

Taking a closer look at the language of section 2, the health officers are not prohibited from keeping sick kids out of the school. They are prohibited from making or enforcing any rules to keep susceptible kids out of school if there is a sick kid identified at the school.

In short, the Department of Health and Human Services, which is charged with minimizing the impact of disease upon the populace, is prohibited from minimizing the impact of disease upon the populace.

It seems that “Raising Healthy Boys” thinks that “waiving 1 vaccine that may have caused seizures or encephalitis” [read MMR] is a good idea, but it’s a clear way to put her special snowflakes at risk. Here’s why:
Risks from measles virus increase with age. The severity of the illness increase with age. Since measles causes immunosuppression for up to several years after infection, the risks from other infectious diseases (including those to which the individual may have been immune prior to the destruction of immune memory) also increases.
We already know, based on information from the last large measles outbreak in this country, that the risk of death from measles virus infection is at least one hundred times the total risk of all adverse events (including the most common serious adverse event: benign febrile seizure.) Moreover, age-adjusted models of measles virus-associated deaths suggest that the majority of those who die will be unvaccinated (even though about 40% of deaths occur in those too young to be vaccinated—infants who rely on herd immunity for protection) and that risk of death from measles virus actually peaks at vaccination levels just below the levels required to eliminate the virus.
We are now approaching that critical point where the children of “Raising Healthy Boys” and their unvaccinated playmates will be at greatest risk. Measles seropositivity was 96% among the 1977 to 1986 birth cohort according to a National Health and Nutrition Examination Survey, but that figure is dropping to dangerous levels: for example, a recent survey of Air Force recruits found that only 82% were seropositive for measles. There are at least 12.5 million US children who are now susceptible to measles, according to the authors of an abstract presented at the recent ID Week meeting, A slight increase in their number (via a 2% drop in MMR uptake) will mean that herd immunity is lost.
Good ol’ Doctor Bob Sears advised his patients to hide in the herd to avoid risk. That sort of selfish free riding may soon be impossible: the herd is disappearing, and Raising Healthy Boys’ children may soon have no place to hide.

@Todd W.: Yeah, the language tripped me up at first too because it’s so poorly worded. After reading and rereading it again a few times, I do think that’s the meaning.

This bill, if passed into law, would forbid local health officers from keeping an unvaccinated child out of school except during an epidemic. Of course, the utter idiocy of this proposed law comes in part from the fact that one of the most effective ways to keep small outbreaks from turning into epidemics in the first place is to act promptly to keep susceptible unvaccinated children away from places where they are more likely to be exposed to the disease; e.g., school. This bill, if it becomes law, would prevent health officials from doing exactly that, thereby hindering their ability to act early to minimize outbreaks.

(1) Pursuant to section 51 of article 4 of the state constitution of 1963, the department shall continually and diligently endeavor to prevent disease, prolong life, and promote the public health through organized programs, including prevention and control of environmental health hazards; prevention and control of diseases; prevention and control of health problems of particularly vulnerable population groups; development of health care facilities and agencies and health services delivery systems; and regulation of health care facilities and agencies and health services delivery systems to the extent provided by law.

How are they supposed to prevent and control diseases if they cannot take steps to minimize the spread of said diseases?

Under the legal powers of the department (section 333.2226), they can:

(d) Exercise authority and promulgate rules to safeguard properly the public health; to prevent the spread of diseases and the existence of sources of contamination; and to implement and carry out the powers and duties vested by law in the department.

I will note, however, that this prohibition only applies to a local health officer, which is defined by state law as “the individual in charge of a local health department or his or her authorized representative”. So the state health officer could exclude susceptible kids from school. School nurses might also be able to do so if authorized by state officials.

It seems so. There’s no limitation as far as I can see to only vaccine-preventable diseases. So if a child shows up at school with any communicable disease that is easily transmitted (let’s say norovirus), but there is no active epidemic declared, local health officers would not be able to legally exclude healthy kids from the school. They would only be able to do so after an epidemic is declared.

Actually, I take back what I said about sick kids being kept out of school. This bill would rescind R 325.175 (PDF) of the Michigan Administrative Code, which states:

R 325.175 Procedures for physicians and schools for control of diseases
and infections.
Rule 5. (1) A physician or other person who attends to a case of communicable disease shall arrange for appropriate barrier precautions, treatment, or isolation if needed to prevent the spread of infection to other household members, patients, or the community. A physician or other person who seeks information on appropriate precautionary measures may request the local health officer or the department to provide the necessary information. Appropriate isolation or other barrier precautions may be instituted for a case or a suspected case of disease, infection, or other condition by the local health officer or the department as necessary to protect the public health.
(2) When a school official reasonably suspects that a student has a designated condition, except for AIDS, HIV infection, and noncommunicable diseases, the official may exclude the student for a period sufficient to obtain a determination by a physician or local health officer as to the presence of a designated condition. The local health officer may initiate the exclusion from school of a student who has a designated condition. A student may be returned to school when a physician or local health officer indicates that the student does not represent a risk to the other students.

With this rescinded, local health officers would no longer have legal authority to keep a child who is sick out of the school. At least, that’s my understanding of the implications of this section being rescinded.

My mistake was to focus on the ambiguous wording of the passage I quoted and to fail to look up that part of the code being rescinded. So, basically, local health officials would no longer have the power, at least under state law, to keep sick children out of school, and they would no longer have the power to keep unvaccinated children out of school if another kid in school were sick except if an epidemic is declared. Does that sound right?

Now what confuses me is why the notice I received mentioned HB 5127, which doesn’t to my reading appear to have any seriously pernicious passages related to limiting the power of local health officials to keep sick or unvaccinated kids out of school.

@raising_unhealthy_boys: Someday your kids will (hopefully) realize how misinformed you are. The greater shame is that you don’t give a sh*t about other children, you freeloading sponge.

Considering your average Tea Partier would enthusiastically give his left nut just for the pure pleasure of watching the next guy lose both of his, merely not giving a shit is their version of deep empathy and concern.

First, if your child has a disease they can spread to others…keep them home.

Secondly, if your child has a compromised immune system…keep them home or at least mask them up.

Third, read vaccine inserts, check out the CDC pages on vaccine studies…talk to your doctor and review your family’s medical history…then make a well informed decision.

Fourth, stop lumping everyone who wants vaccine safety looked into as a crack-pot. Please remember that the same doctors and health professionals telling you ALL vaccines are safe for ALL children are the same group of people who once told us DEET and smoking were safe.

Fifth, every new advancement in medical science makes a previous advancement obsolete. Without people pushing for better medical treatment and care, medical treatment stagnates and we become no better off. Remember it took almost 30 years for doctors to accept hand washing between patients as a preventative measure at transmitting diseases. The science should never be considered done and over with on any medical issue.

Sixth, please recognize that the United States Supreme Court has even acknowledged that vaccines are unavoidably unsafe and that people cannot sue vaccine makers for bad vaccines or vaccine damages. This causes mistrust. Why can one sue if a pill causes unexpected damage but one cannot sue if a vaccine does the same?

Seventh, if you are so concerned about the vaccine rate in your community, instead of fighting one another, both sides should be working together to make vaccines safer. With something as serious as preventable transferable disease care, there should be no reason why we do not have a way to assess individual reaction risk to preventative care.

Eighth, understand that once a child is vaccine injured, nothing can be done to reverse it. Yes, you may feel that by not vaccinating, a parent is leaving his or her child open to developing these diseases but in their eyes, at least these diseases are treatable, if not always preventable. You have no way to treat or prevent a vaccine injury.

Ninth, once the government is allowed to mandate anything health related, it opens up the door to more government mandates. We have seen it done in many other areas of life, healthcare will be no different.

Tenth, you are not going to sway anyone to come to your side of the argument by calling names, being hostile, refusing to take part in a logical discussion, and not honestly trying to see the other person’s view point.

Now my kids are in the very middle of this debate. I have one son who is moderately vaccinated and another who has only received one vaccine. I made my decision not to continue with vaccination based on family history of adverse reactions, family history of neurological diseases, family history of autoimmune diseases, and the inability to get vaccines given in one shot increments, spaced out between doses. I had an aunt become an invalid due to vaccine injury (yes, it was medically agreed and documented that it was an adverse vaccine reaction), I have another aunt who developed Lupus, my mother has Multiple Sclerosis, my brother died of leukemia which tested positive for SV40 markers, and I have Multiple Sclerosis. Considering most vaccine inserts state a correlation (yes, I understand correlation does not equal causation) to Lupus, Multiple Sclerosis and Leukemia, I feel it is best not to expose my children to anything that could possibly increase their chances of developing these life-altering and life-stealing diseases since they are already so prevalent in my family.

Does this make me an anti-vaxxer? No, this makes me a mother who wishes vaccines were safer and did not have such correlations so that she could in good conscience get her children immunized.

If you want everyone immunized, demand safer vaccines and ways to determine whose body can handle the adjuvants and whose cannot.

I could be wrong in my reading, or there might be some other law, regulation, or rule authorizing the exclusion of sick kids from school, but this bill just went from merely “a really, really bad idea” to “batsh*t insane”.

@orac. Hooked is also the rep with his panties in a twist over high school students getting appropriate sex ed. His delicate sensibilities are upset by students putting condoms on cucumbers. He literally wants to ban putting condoms on food.

It’s not up to the children to protect us….we all need to go get ALL our shots now! Well, I already have….have YOU???

If that’s a “gotcha” it won’t work on this board, toots. Yes, I’ve had all the shots recommended for adults living in the continental US, and also all the ones recommended for those unhealthy parts of the world I used to be sent to on a regular basis.

The link between Tea Party/conservatives and vaccine “freedom” is rich. For the communicable disease part, who freaked out the most with Ebola? These folks wanted to block all travel with the concerned countries, even for American citizens. The quarantine for “suspected” case was insane. As for the requirement for a counseling session (that’s weak, mind you), how can they reconcile that with their requirements for abortion ?

Takiar, you beat me to it. Had I not had my comment wiped out from that annoying touchpad issue in Windows, I would have had this in:

“… local health officials would no longer have the power, at least under state law, to keep sick children out of school, and they would no longer have the power to keep unvaccinated children out of school if another kid in school were sick except if an epidemic is declared.”

This power is supported within a conservative stance. What the heck happened here?

This bill, if passed into law, would forbid local health officers from keeping an unvaccinated child out of school except during an epidemic.

Had an infection preventionist thought: what is the definition of “epidemic?” There are many diseases where one case is considered an “epidemic” by the professional standard. I know where I practice, for something no longer endemic to a region (ie measles, diphtheria) one would be enough in a population like a school. Here, ONE case of hospital-acquired influenza is enough to NYS to declare an outbreak in your facility. Not that the law is any less sh*t and antivaccine. Chicken pox wouldn’t fly.

So, WHAT is the exact definition of “epidemic” here? I could see this going in public health practitioners’ favors, but also maybe against it, as while I know one incidence of measles is technically an epidemic in a non-endemic country, the masses won’t.

“If they had truly been an educational session it would have also included the covered risks that are mention in the pages of documentation that comes with each vaccine.”

“You really don’t want parents educated.”

Are you on-board for educating on the dangers of VPD’s?

Vaccines make me feel ill for a few days. However, I could have done without the two weeks of chickenpox and I’m sure my best friend would have liked to not go though the hell of measles if given the choice.

Orac, let’s not get too excited about these bills. They’ve only been introduced, had a first reading, and been referred to a committee.http://www.legislature.mi.gov/(S(rzegnwpcwcxxvazugrriwm15))/mileg.aspx?page=getObject&objectName=2015-HB-5126http://www.legislature.mi.gov/(S(rzegnwpcwcxxvazugrriwm15))/mileg.aspx?page=getObject&objectName=2015-HB-5127
Any Rep can “introduce” anything. That doesn’t mean it’s going anywhere. Many bills get referred to committee, only never to be heard from again. Even if these beauties getting passed by the House and Senate, and I doubt they stand any real chance, I don’t see Snyder signing the legislation into law.

As for painting the MI House as being stacked with Tea Party types, I think that the Courser/Gamrat kerfuffle showed that there were plenty of non-aligned GOP house members that more than happy to see these two Tea Party standard bearer get booted. Ironically, is was the Democrats that threatened to scuttle their exit.

@ Gizmo, I do hope you are correct but there is no harm in keeping some feet to the fire on this. After reading Todd’s comments in particular, it really is a BS insane bill and would cause astounding physical and economic harm.

Note to you whacko anti-vaxx freedumb parents: Your children are not your property; you are their stewards. No one is forcing vaccination on you or your children so stuff the hyperbolic whining rhetoric already.

I’m not really sure where you got the information that the new “education class” is working. Michigan Radio reported that it’s not making much of a difference at all. http://michiganradio.org/post/thousands-michigan-parents-want-vaccination-waivers-despite-info-sessions#stream/0
The Macomb County medical director is interviewed saying it’s not really changing people’s minds about the vaccinations: “The parents who are making these waiver appointments are very committed [to getting those waivers.] I’m not aware of any changing minds,” he says. Instead, the TAXPAYERS are paying a ton of money in vain on these classes and staff members for thousands of hours spent with parents who are committed to their resolve on the matter.

Furthermore, it strikes me as odd that you would be more concerned about excluding a non-vaccinated child who is not contaminated than you are about excluding a vaccinated child who is ill. Simple biology will tell you that a child (vaccinated or not) who does not have a virus, cannot spread a virus. But a child (vaccinated or not) who does have the virus can and will contaminate others. In addition, incubation times for these viruses are the same in all exposed children (vaccinated or not). Healthy children do not need to be excluded from school, sick ones do.

Furthermore, it strikes me as odd that you would be more concerned about excluding a non-vaccinated child who is not contaminated than you are about excluding a vaccinated child who is ill.

Actually, you are mistaken here. I think it’s quite important to exclude a child with a vaccine-preventable disease, regardless of whether the child is vaccinated or not. There was simply some confusion over whether this bill would actually prevent health officers from doing that. Now that we’ve worked out that, yes, it would eliminate the power of local health officers to exclude sick kids from school, I am now even more alarmed at this aspect of the bill than I was at its removing the power of health officers to keep unvaccinated children out of school when there is a case of vaccine-preventable disease there.

As for whether this is working, it’s too early to tell. The article you cited actually does shed some light on what antivaxers are claiming about their supposedly being told they’re not eligible. For example:

“Objection to vaccine for religious reasons may be masking the parent’s or guardian’s real question regarding safety, which is not a true religious objection. This would be a philosophical objection. However, understanding and acceptance may need to occur in regards to a person’s religious beliefs.

Perhaps some parents were being told that their objections were not religious objections but philosophical objections and thought that meant they were being told they weren’t eligible.

Then:

Yet in Oakland County, Bies says about a third of parents who go through the education sessions say they do plan to follow up on what they’ve learned, either with the county or with their own doctors.

He says a sizeable chunk of the parents they’re seeing aren’t so much anti-vaccination as “vaccination hesitant.”

“And when they do that, they kind of fall into those situations where they don’t have their child fully vaccinated, but they will try to follow up in one to two years to get their child fully vaccinated.”

Nobody is forcing anybody, not even children, to be vaccinated. This, incidentally, is why as Vaccine Mommy pointed out, adults tend to be underimmunized. There is no law which says you must administer even one vaccine to your child, and certainly none requiring any adults to be vaccinated.

BUT.

Institutional settings are at particular risk of disease outbreaks. Thus, it is very much in their interest to have people in the institution be vaccinated. Public schools, administered by the government, are no different and generally require a subset of the CDC recommended vaccine schedule. (That’s right; they don’t actually require all the things the CDC recommends, and the CDC’s recommendations remain just that: recommendations. Not mandates.) They may or may not also require the staff to receive vaccines, but as the student body tends to be the largest, most concentrated source of infectious contact, that’s the most important one to get vaccinated. Other institutional settings, such as hospitals and clinics, frequently require a specific set of vaccines for the staff, since if there is an outbreak, a lot of the infectious patients can be expected to end up there at some point.

So what this means is that while nobody is forcing you to vaccinate your child, you may have to homeschool them if you decline and don’t have a legitimate medical excuse, like an egg allergy or something. And even in that case, you are responsible for using alternate means of removing the child from the infectious pool of students during an outbreak. In other words, quarantine compliance.

Adults are undervaccinated because except for those working in certain institutional settings, there is no penalty for not vaccinating. So the fact that the vast majority of adults aren’t up to date is pretty clear evidence that we do not, in fact, force anybody to get vaccinated. School entry requirements have nothing to do with protecting the general population (although as bonus, they definitely do). They’re about protecting the student body.

Nikki: Secondly, if your child has a compromised immune system…keep them home or at least mask them up.

You do realize masks don’t stop everything, don’t you? Secondly, should immuno-compromised adults and kids just sit at home forever? No grocery trips, no friends, no parties, no school, no sun? Because that sounds kind of what you’re advocating for, just as long as YOUR kids go unpricked. Would you be okay with never letting your kids go outside if they developed cancer or had to take immuno-suppressants because one of their organs had to be replaced? Of course, if that happened, you would probably disown the kid, since anti-vaxxers can’t stand disabled people.

“Vaccine safety” is how anti-vaxxers try to justify their scientifically and medically unjustifiable vaccine refusal for their children. You want things impossibly safe in your deluded little worlds. While you’re at it, stop using seat belts for your children as well, because, well–you know, they’re not 100.0000000% safe. Same with eating food (any food!) or drinking water from a municipal supply. In fact, if you’re using a laptop, the Li-ion battery can catch fire–better shut it down. In fact, just stop breathing right now, because life is inherently followed by death, no matter what you do, so why bother with another day, eh? Why bother with common sense public health measures like vaccination when we can go back to the days when so many died or were maimed from whooping cough, tetanus, diphtheria, meningitis, measles and chicken pox?

No, I’m done with the ridiculously moronic drivel from you AVers and even slimier “vaccine safetiers”. You’re all cracked pots. You are all deluded into thinking you can just read crap on the internet and become an expert. How many of you fix your cars based on the internet? Yeah, I thought so…and cars are much simpler than humans. Yet you’ll make health decisions based on Facebook group concensus? You AVers/Safers are all quite the elitist freeloaders living on heard immunity. Don’t believe me? Go look at the VPD rates in Mississippi and West Virginia where your lot has to (by law) keep your electively unvaccinated kids home from school (as you should) . They don’t have VPD outbreaks in Mississippi and WV like in Michigan (or AZ where I live and AVers abound with their lunacy) because (and only because) they have 99.5% or greater school vaccine rates which equal excellent herd immunity. News flash for you: everybody’s snowflakes are just as special as your oh-so-extra-special darling little snowflakes, and diseases spread in schools. So just go stuff it in your Christmas stockings along with the lumps of coal you so deserve.

But a child (vaccinated or not) who does have the virus can and will contaminate others. In addition, incubation times for these viruses are the same in all exposed children (vaccinated or not). Healthy children do not need to be excluded from school, sick ones do.

Since the child often shows no symptoms during incubation period, it becomes difficult to determine which children are contagious and which are not. Keeping sick children out of schools is certainly important; in order to protect healthy, but unvaccinated, children it may be necessary to keep them home during an outbreak.

I’m so glad to know my child with Down syndrome should just sit at home her whole life instead of getting out with other young adults, learning, experiencing. She should just shut up and deal with her immune system because someone else thinks their speshul sneauxflake shouldn’t have to be vaccinated against potentially lethal diseases, or if they are infectious, the rest of us should just be strong enough to deal with it. The weak should not be seen.

I have a few suggestions for these people that involve autoeroticism and an oxidized chain-driven saw.

My youngest had a serious reaction to the pertussis vaccine.( swelled up had trouble breathing) We had to go to the hospital, she was fine after they got it all under control. It was very scary. Her doctor a elderly man who had been a doctor for a long time said he’d never seen that happen before , so it must be rare.

She’s perfectly fine now

I still see that as not a reason to not vaccinate, both her (except for pertussis for obvious reasons) my eldest , myself and my ex are fully vaccinated, and get flu shots every year.

Youngest caught whooping cough at three and that was a terrifying three months with time at the hospital, I don’t know why anyone with no real reason for not being vaccinated would even risk such a thing.

My kids and i are all on the autism spectrum, it’s not the worst thing to be, dead is much worse, not that vaccines have any relation autism at all, I suspect it’s genetics.

I’ve always been fascinated with how seductive the ‘correlation as causation’ fallacy is.

I’ve lost count of how many times I’ve seen someone preface something with ” now, I realize that correlation is not causation…” and they then follow it up “BUT OH MY GOD JUST _LOOK_ AT THAT CORRELATION!1!one!”

People just can’t get past that fallacy. Even when, on a surface level they understand what it is, they are still drawn in as if by the Harpies on the rocks…

First, if your child has a disease they can spread to others…keep them home.

Of course, but a few things: 1) they will be infectious before they show symptoms; 2) we have documented evidence of people not keeping their sick kids home even when they are showing symptoms; and 3) the bill would actually remove the authority for local health officers/physicians/school officers to exclude sick kids from school.

Secondly, if your child has a compromised immune system…keep them home or at least mask them up.

As others noted, masking has limitations, even when worn properly. And why should an immunocompromised child have to do that? What about their rights to socialize and go out? Your fear of a quick needle prick trumps their freedom to live without fear of contracting a disease from your susceptible child?

Third, read vaccine inserts, check out the CDC pages on vaccine studies…talk to your doctor and review your family’s medical history…then make a well informed decision.

This is good advice, actually. And a reasonable person, after doing so, would support vaccine requirements for school.

Fourth, stop lumping everyone who wants vaccine safety looked into as a crack-pot. Please remember that the same doctors and health professionals telling you ALL vaccines are safe for ALL children are the same group of people who once told us DEET and smoking were safe.

So, you want us to not stereotype folks who make anti-vaccine arguments, while you, in the next sentence, stereotype public health professionals? Also, it was the larger scientific community who told people that smoking is harmful, based on abundant, robust evidence. Yet you advocate not listening to scientists on vaccines, despite abundant evidence that they are safe. (Also, nice strawman there. Show me a doctor who says that ALL vaccines are safe for ALL children. There are these things called contraindications, which doctors follow, and which are listed in the vaccine inserts you ought to have read according to your point #4. These would be grounds for a medical exemption.)

Fifth, every new advancement in medical science makes a previous advancement obsolete.

As others pointed out already, not true. We’ve made enormous advances in life support, but that doesn’t mean that vaccines to prevent diseases that lead to needing life support are obsolete.

Without people pushing for better medical treatment and care, medical treatment stagnates and we become no better off. ..The science should never be considered done and over with on any medical issue.

Yes, promote better treatments and care. For instance, we need a better pertussis vaccine; one that is more effective and longer-lasting. However, just because the current one isn’t the ideal doesn’t mean we should not use it in the meantime to reduce the overall burden of disease.

Sixth, please recognize that the United States Supreme Court has even acknowledged that vaccines are unavoidably unsafe and that people cannot sue vaccine makers for bad vaccines or vaccine damages.

The reality is a bit more nuanced than what you state. First off, “unavoidably unsafe” applies to a hell of a lot of stuff in your life. Seatbelts are unavoidably unsafe in that they carry some risk of injury, even when used as intended. The reason that design defect claims are required to go through VICP is because there is no fault on the part of the manufacturer: the product is designed appropriately and nothing the manufacturer could do would change the risk/benefit profile.

Seventh, if you are so concerned about the vaccine rate in your community, instead of fighting one another, both sides should be working together to make vaccines safer.

I’ve actually supported research to do just that. I have yet to see anti-vaccine activists do so. All they do is rant and rave about how vaccines are supposedly the worst thing ever invented. So you’re really talking to the wrong crowd on that one.

With something as serious as preventable transferable disease care, there should be no reason why we do not have a way to assess individual reaction risk to preventative care.

I can think of a reason: there is no test currently available which would do this. And another: any such test would have to be extremely accurate, with very low false positives/negatives. Oh, and another: any such test would have to be really, really cheap and affordable. Ah, and one more: negative reactions to vaccines would have to occur at such a high rate as to make all of that cost-effective. So, you’re donating to support research into the development of such a test, right?

Eighth, understand that once a child is vaccine injured, nothing can be done to reverse it.

Yes, we readily acknowledge that. And it is horribly tragic when it happens. But we also understand that once a child is disease injured, nothing can be done to reverse it. And disease complications happen at a much greater rate than vaccine injuries.

Ninth, once the government is allowed to mandate anything health related, it opens up the door to more government mandates. We have seen it done in many other areas of life, healthcare will be no different.

Nice hypothetical. What is your evidence to support that this is the case, particularly as regards vaccines?

Tenth, you are not going to sway anyone to come to your side of the argument by calling names, being hostile, refusing to take part in a logical discussion, and not honestly trying to see the other person’s view point.

I assume that you also address this concern to the anti-vaccine movement, who regularly compare those in favor of public health to Nazis, Hitler, baby-eaters, rapists, prostitutes, etc.?

Does this make me an anti-vaxxer? No, this makes me a mother who wishes vaccines were safer and did not have such correlations so that she could in good conscience get her children immunized.

No. What would make you an anti-vaxxer is if you were to go about spouting demonstrably incorrect information or arguments about vaccines, as well as if, by doing so, you scared people away from vaccinating.

If you want everyone immunized, demand safer vaccines and ways to determine whose body can handle the adjuvants and whose cannot.

Already doing that by directly supporting research. What are you doing?

Tenth, you are not going to sway anyone to come to your side of the argument by calling names, being hostile, refusing to take part in a logical discussion, and not honestly trying to see the other person’s view pointby thoughtlessly repeating stock antivaccine talking points that you’re too lazy even to think about.

@ Science Mom
Oh, I agree that the bills are worth noting, I’m only questioning Orac’s description of our legislature and I think he overstates the chances that the legislation will gain traction. I think the recent memory of the Pertussis outbreaks last winter in the Traverse City area will provide plenty of counter-arguments.

Todd W. @94
Thanks for linking to Professor Reiss’s clear explanation that, as Narad notes, the Supreme Court did not apply the term “unavoidably unsafe” to vaccines.

Regardless of the real meaning of the term “unavoidably unsafe,” it is understandably disturbing to parents to hear that the Supreme Court described the vaccines given to their children using that scary term. Fortunately, it didn’t.

@Gizmo. I’ve had some experience interacting with the legislature, and I stand by my description. It’s been taken over by Tea Party wing nuts and can’t even get its act together enough to fix the roads. (Also remember that my state senator is Patrick Colbeck. Just check out his Facebook page and Twitter feed if you want the purest distillation of climate science denialism, antivaccine tendencies, and unabashed worship of Ted Cruz.)

Does that mean this bill will gain traction? Who knows? What I do know is that this legislature is good at passing bad bills quietly, which it did with the right-to-try law. So I take nothing for granted as far as the stupidity of our state legislature goes and therefore want to do whatever I can to shine a little light on these bills.

I’ve often wished for a rear-facing car seat that is easy as pie to install. Given that car accidents are a leading cause of M+M in kids, given that so many car seats are difficult to install and often not used correctly…I should probably just stop using a car seat altogether, given that the technology isn’t perfect and there’s clearly room for improvement. I know there are laws and stuff, but it’s my kid and I know what’s best for her.

Mr Hooker: I am extremely disappointed that a state representative would introduce bills that have such a negative effect on public health. For a man with your apparent background, you should know that quarantine is an important part of preventing the spread of diseases. And if that means a child can’t go to school because they haven’t been vaccinated against a disease that is occurring in the school, so be it. You should be representing ALL of your constituents, even those who are too young, too ill, too elderly or unable to be vaccinated by encouraging those who can be vaccinated to do so and protect their fellow humans.

While I am no longer a Michigan resident, I still have family members who live there – including those who attended Grand Valley. We are all proud of being from Michigan. Please don’t make it an embarrassment

I no longer live in Michigan but I do still vacation there every year with my young son to see friends and family (and, maybe even more importantly, the beach!). This is very disappointing.

One angle to fight this would be the impact it might have on tourism. Michigan makes a LOT of its money from tourism, and I know I will be a little more reluctant to vacation there if there is an increased chance of infection.

I’m in kind of a pre-travel frenzy, so I haven’t read Dorit’s entry, but the reason the Bruesewitzes tried to advance this theory is because it might have entitled them to a case-by-case review at the state level.

Nikki:
One thing, perhaps you should do some research (looking up actual scientific papers, though I don’t know if you know how to do that) on the difference between DEET and DDT. DEET is a common insect repellent, safe to use for a period of time on clothing and skin. DDT is a pesticide, but no one ever advocated using it on clothing or skin and it was never considered very safe, even before the raptor population went into a decline. It’s stuff like that that makes people think that anti-vax people don’t do any research and are actually rather dim.

I’m not really sure where you got the information that the new “education class” is working. Michigan Radio reported that it’s not making much of a difference at all. The Macomb County medical director is interviewed saying it’s not really changing people’s minds about the vaccinations: “The parents who are making these waiver appointments are very committed [to getting those waivers.] I’m not aware of any changing minds,” he says.

Two different questions here. 1) Is the new rule making a difference? Yes. It is bringing the total number of non-medical exemptions down. 2) Is it changing the minds of the die-hards? No, but that’s not its aim. The reason that #1 is true is that its getting the fence-sitters and those who just use the non-medical exemptions as a convenience. No amount of evidence will change the mind of a die-hard anti-vaxxer (except in some exceedingly rare instances). But when those waivers are easy to get, parents may use them simply because they forgot to take their kid in on time and, rather than actually making time to get their kid immunized, they just send in the waiver so their kid isn’t kept home. And then they forget about it. Or maybe they would like to immunize their kid, but they think that doing so is too burdensome, so they go the easier, lazier route. For any variation of these, making getting an exemption equally as burdensome as getting vaccinated removes the incentive of the exemption. And then there are some who actually aren’t adequately informed, but aren’t necessarily wedded to the idea that vaccines are bad. For those parents, education actually may work. It may not be many, but it adds up.

Furthermore, it strikes me as odd that you would be more concerned about excluding a non-vaccinated child who is not contaminated than you are about excluding a vaccinated child who is ill.

No one said any such thing. Keeping sick kids home is important. But it is also important, when there is a case identified, to keep susceptible kids home, too, to prevent the spread of disease to them and to others.

Simple biology will tell you that a child (vaccinated or not) who does not have a virus, cannot spread a virus.

Simple biology also tells you that a child who does not have a virus and is susceptible to that virus can contract the virus from those who already have it. And as we seem to have to keep reminding people, those who are infected are often infectious before they show any signs or symptoms that they are sick. Even after they start to show symptoms, their parents might not keep them home, especially if they think, “Oh, it’s just a cold.” “It’s just a cold” describes the early symptoms of an awful lot of diseases.

In addition, incubation times for these viruses are the same in all exposed children (vaccinated or not).

Not really. They are close, but there is always some variability in the time it takes for the virus (or bacterium) to incubate.

Healthy children do not need to be excluded from school, sick ones do.

Keeping susceptible children in school when an infectious student is present is a really good way to turn healthy children into sick children.

Has anyone pointed out that tiny babies depend on the herd before they’re old enough to be immunized? Should us parents here in Ontario just keep our babies at home until they’re at least a year and get their first dose of MMR? Until 15 months when they get varicella? Or do we just make them wear masks in public? I know, I know, Maughmees, passive immunity! But you think your Magikal Breastmilk is a lot more protective than it is in reality. And you gotta be immune yerselves in order to confer any form of immunity to your snoflake.

Interesting way to start, and then she says: ” Do your readers know that waiving 1 vaccine that may have caused seizures or encephalitis still is falls into your 5 % drop in waiver rates?”

Oh, really? Please post the PubMed indexed studies by reputable qualified researchers that any vaccine on the present American pediatric schedule causes more seizures or encephalitis than the disease. I ask because my now adult son had seizures as a toddler from an actual disease several years before its vaccine was available.

Then she ends up with: “Obviously with our Vaccine Court paying out 3.18 billion dollars in claims for vaccine injuries, there is reason to pause and educate yourselves. ”

Could you do a little math problem for me? Go to the first table of the NVICP statistics. Go to the last row marked “Grand Total”, and find the total number of vaccines given in the specified time period (2,532,428,541 vaccines). Now run your finger over the column to find the total number of compensated claims during the same time period (2068 compensated). Now divide the first number by the second number. What is the result, and what does it mean?

Does this make me an anti-vaxxer? No, this makes me a mother who wishes vaccines were safer and did not have such correlations so that she could in good conscience get her children immunized.

No, what makes you an antivaxxer is mindlessly parroting antivax propaganda that you obviously couldn’t be bothered to fact-check for yourself. So spare us your pearl-clutching “how dare you criticize me for being a such a Good Mother” BS, since you obviously didn’t care enough about your kids’ health to vet the sources you use to make health care decisions that could affect them for the rest of their lives. Just to add my two cents to what’s already been said:

Please remember that the same doctors and health professionals telling you ALL vaccines are safe for ALL children

And what doctors and health professionals would these be? Obviously, that’s a rhetorical question because there aren’t any except in antivax fantasy-land – that was the first thing that gave you away.

Sixth, please recognize that the United States Supreme Court has even acknowledged that vaccines are unavoidably unsafe and that people cannot sue vaccine makers for bad vaccines or vaccine damages.

Apparently you couldn’t even be bothered to read the legislation to which you refer (the National Childhood Vaccine Injury Act of 1986.) To be fair, the act itself is written in near-incomprehensible legalese, but there’s a good summary at the beginning of the Supreme Court case Narad mentioned (the one where they rejected the claim that vaccines are “unavoidable unsafe.”) I’ll even quote you the relevant passage:

The Act provides that a party alleging a vaccine-related injury may file a petition for compensation in the Court of Federal Claims, naming the Health and Human Services Secretary as the respondent; that the court must resolve the case by a specified deadline; and that the
claimant can then decide whether to accept the court’s judgment or reject it and seek tort relief from the vaccine manufacturer [emphasis mine]

Considering most vaccine inserts state a correlation (yes, I understand correlation does not equal causation) to Lupus, Multiple Sclerosis and Leukemia…

No, what vaccine inserts state is that people have reported developing various ailments after receiving a vaccine. See the difference? You know what is an interesting correlation, though? The “vaccine injuries” that get reported to VAERS tend to correlate to litigation or published vaccine scares. In other words, anyone can claim that vaccine cause x, and soon enough people will start reporting that they developed x after receiving a vaccine, making the “reported” side effects section of a vaccine insert completely useless for judging actual risk.

I feel it is best not to expose my children to anything that could possibly increase their chances of developing these life-altering and life-stealing diseases since they are already so prevalent in my family.

Well, if their immune systems can’t handle a vaccine, they sure as heck can’t handle an actual disease, so I hope you’re following your own advice and either confining your special snowflakes to the house or making them wear a mask whenever they venture out.

Nikki: “… you may feel that by not vaccinating, a parent is leaving his or her child open to developing these diseases but in their eyes, at least these diseases are treatable, if not always preventable. You have no way to treat or prevent a vaccine injury.”

I missed this due to her long ramble. Nikki, “treatable” for these diseases often includes hospital care. Even still, the mortality rate for tetanus and diphtheria is very high. Encephalitis occurs in about one in a thousand cases of measles, with pneumonia happening to even more cases.

Why do you think that is a good idea? Also, why would a parent want their child to suffer high fevers, pain and seizures? That sounds like something only a sadist would wish on helpless kids.

The Act provides that a party alleging a vaccine-related injury may file a petition for compensation in the Court of Federal Claims, naming the Health and Human Services Secretary as the respondent; that the court must resolve the case by a specified deadline; and that the
claimant can then decide whether to accept the court’s judgment or reject it and seek tort relief from the vaccine manufacturer [emphasis mine]

Not to get reductionist or misuse Dawkins or anything (heh), but this item (forbid health officials from keeping both sick kids and unvaxed kids out of school during outbreaks until they become epidemics) strikes me as straight-up Selfish Gene competition via social Darwinism:

“My special snowflake is protected by my special genes (and our organic diet, and regular coffee enemas), so s/he won’t get sick, but those other kids, the genetically inferior ones over there who had cancer treatments or have compromised immune systems, will get sick and some of them will be knocked out of the gene pool, which is good for me & mine!”

Never underestimate the power of atavistic instincts to express themselves via legislation.

—

Todd W @ 49: That’s a possible workaround: the state health officer issues some kind of declaration that delegates authority to the county health officers. But it’s a sure bet that any such maneuver would be immediately challenged in court, and potentially tied up with an injunction and a lengthy proceeding, during which time the outbreak spreads. We shouldn’t accept “workarounds” for this or for other emergencies.

—

Gizmo @ 67: Re. “newly introduced…”

Yes we should get up in arms about this now. The time to deal with bull stuff is when it’s fresh from the bull. Don’t give it time to fester and spread germs.

—

Sean @ 99: Tourism.

I think it’s a great point. I have no intention to travel to states that are going backward on public health. The attitudes that lead to low immunization rates also lead to poor sanitation & hygiene, etc. (“don’t worry, it’s natural!”). And the attitudes that are lax on public health regs do not bode well for things such as restaurant safety.

Maybe we should have a “new state tourism slogan” contest for Michigan.

Bumper sticker: “Come to Michigan, and stay a while longer (in the hospital)!”

T-shirt: “I vacationed in Michigan, and all I got was this T-shirt (but my kid got the measles)!”

@ Narad – Darn it, I knew I’d get it wrong. But I’ve read and re-read Bruesewitz and I don’t see anything contradicting the passage I quoted. Do you simply mean that, practically speaking, no one can win a design-defect case against a vaccine manufacturer because they’ll simply cite Bruesewitz as a precedent?

Am I at least correct in thinking that the following passage:

They are immunized
from liability for punitive damages absent failure to
comply with regulatory requirements, “fraud,” “intentional
and wrongful withholding of information,” or other “criminal
or illegal activity.”

…means that vaccine manufacturers can still be sued for ” failure to comply with regulatory requirements, “fraud,” “intentional and wrongful withholding of information,” or other “criminal or illegal activity?”

But I’ve read and re-read Bruesewitz and I don’t see anything contradicting the passage I quoted. Do you simply mean that, practically speaking, no one can win a design-defect case against a vaccine manufacturer because they’ll simply cite Bruesewitz as a precedent?

No, I’m saying that it’s no longer possible to bring a state design defect claim. The appeals path after the Office of Special Masters is to the Court of Federal Claims proper (which just amounts to checking that the Special Master didn’t careen off the rails), then to the Court of Appeals for the Federal Circuit, and then to the Supreme Court.

I believe that two cases have made it to the final step, but that’s all there is. Now, one could look askance at the decision’s being based on a textual analysis, but the simple fact of the matter is that federal preemption was more or less inevitable: Not only are such state lawsuits a complete crapshoot to start with, but having 50 different sets of rules only magnifies the issue.

The question then becomes whether Congess, considering the totality of the law, was really setting forth a public policy based on choosing doors à la “The Price Is Right.”

Am I at least correct in thinking that the following passage:

They are immunized from liability for punitive damages absent failure to comply with regulatory requirements, “fraud,” “intentional and wrongful withholding of information,” or other “criminal or illegal activity.”

…means that vaccine manufacturers can still be sued for ” failure to comply with regulatory requirements, “fraud,” “intentional and wrongful withholding of information,” or other “criminal or illegal activity?”

Not particularly. This passage is merely a restatement of
§ 300aa–23(d)(2). Limitations on extraordinary damages aren’t of particular interest if one never gets to the damages phase in the first place.

There are two product-liability bases upon which one could attempt to proceed in state court: manufacturing defect and warning defect. The latter is almost certainly untenable, as the FDA approves the labeling. In the case of the former, yes, if it actually occurred, it would be a free-for-all class action, but it would have to be a truly massive screwup.

There’s been at least one case, as I recall (this may predate Bruesewitz), that attempted an end-run by suing the manufacturers of thimerosal per se, because it’s a component rather than a vaccine. It didn’t work out, but I can’t really look deeper right at the moment.

vaccine manufacturers can still be sued for ” failure to comply with regulatory requirements, “fraud,” “intentional and wrongful withholding of information,” or other “criminal or illegal activity?”

At this point, one is looking at add-ons to something else. The main thing going, as it were, at the moment is Krahling & Wlochowski’s suit under the False Claims Act, which claims that Merck (or whoever) doctored the efficacy numbers on the mumps component of MMR-II.

That’s pretty much fraud, but if they get their payday, the only people who seem likely to sue are those who didn’t receive the protection they paid for. Everything else seems to rest on the bringing of federal charges to lever a state action.

Ok, so I think what I’m confused about is the distinction between the state and federal court. The judge says that plaintiffs “can seek tort relief from the vaccine manufacturer;” you say “not since Bruesewitz, because its no longer possible to bring a state design defect claim.” Does the term “tort relief” apply only to state law?

Chris: Nikki, “treatable” for these diseases often includes hospital care.

You’re assuming that anti-vaxxers would want to take their kids to the hospital, rather than ineptly nursing them. That’s a rather big logical leap. (Also assuming that an anti-vaxxer wouldn’t be fine with just letting their kids die, but that’s another story.)

Where do you see that the waiver rule is actually bringing waiver numbers down? I cited a source. Where’s yours?

Even before the rule change, exemptions were not the “easy, lazy” way to go. 99% of the time we still had to listen to doctors, friends, and family member lecture us. Doctors would take forever to get the waiver form, making us wait extra time. Schools and daycares would misplace those forms and we’d have to jump through hoops to get them. It’s only slightly more annoying now than it was before, except the major difference is the amount of money being paid by the taxpayers to fund this rule program.

I don’t think I understand your concept of a “susceptible” child. You do know that every child is susceptible to these illnesses right? Vaccinated children are susceptible to chicken pox as well. If they weren’t, you all wouldn’t mind so much if there were non-vaccinated children around your own kids, or more so, ill children with the disease. Logically, if you’re worried about incubation times when a so-called preventable disease is exposed in a school, then EVERY child should be excluded for those 21 days. Even if your own logic held true and vaccinated children had a slightly lower incubation period than nonvaccinated children, then they should be excluded from school for 19 days and the vaccinated children excluded for 21 days.

Furthermore, even the CDC, FDA, and vaccine manufacturers admit that there can be severe and devastating side effects. The point of contention is how often those side effects happen. We don’t need to argue about that, suffice to say that we differ in opinion there. The point I would like to make is that if something carries a risk, everyone deserves a choice. When someone has cancer and there’s a 99.99% chance that a surgery will successfully remove it, the patient and/or the family is given a choice. I don’t want to persuade anyone else not to get vaccines. That is absolutely your choice. And I wish you well. I would just like to have the same consideration given to me.

There’s been at least one case, as I recall (this may predate Bruesewitz), that attempted an end-run by suing the manufacturers of thimerosal per se, because it’s a component rather than a vaccine. It didn’t work out, but I can’t really look deeper right at the moment.

Ok, so I think what I’m confused about is the distinction between the state and federal court. The judge says that plaintiffs “can seek tort relief from the vaccine manufacturer;” you say “not since Bruesewitz, because its no longer possible to bring a state design defect claim.” Does the term “tort relief” apply only to state law?

No, I think what’s going on is that you’re looking at a small passage from the law itself. The Bruesewitz decision nixed that bit. Design defect claims are wholly federally preempted.

I don’t think I understand your concept of a “susceptible” child. You do know that every child is susceptible to these illnesses right? Vaccinated children are susceptible to chicken pox as well. If they weren’t, you all wouldn’t mind so much if there were non-vaccinated children around your own kids, or more so, ill children with the disease. Logically, if you’re worried about incubation times when a so-called preventable disease is exposed in a school, then EVERY child should be excluded for those 21 days.

This is simply trying to turn the usual Nirvana fallacy routine* on its head. It’s bad faith all the same.

Maria: “Vaccinated children are susceptible to chicken pox as well. If they weren’t, you all wouldn’t mind so much if there were non-vaccinated children around your own kids, or more so, ill children with the disease.”

Oh, do please provide the PubMed indexed studies by reputable qualified researchers that children who have had two varicella vaccines are just as susceptible to chicken pox to those who have not had a varicella vaccine.

All of my kids got chicken pox in 1994, a full year before the vaccine was available. It was an outbreak that caused a good third to half of the school where my oldest to be absent for well over a month. Obviously the varicella vaccine my oldest did not get was not the reason he could not speak at age three (he got chicken pox in kindergarten).

All of my kids had almost a full two weeks of fever and covered by itchy pox. Including the six month old baby (who despite the pox near her eyes, did not have any problems and graduated Cum Laude from college earlier this year… she still has a higher chance of shingles). You need to provide a very good reason to want any kid to suffer even a few days with fever and covered with dozens of itchy open wounds to convince me the vaccine is not useful.

Perhaps it is because after twenty years of your responsible neighbors who vaccinate, you have absolutely no clue how much pain is caused by chicken pox. Be sure to thank those neighbors who protect your family by maintaining your community’s immunity.

Ok…I re-read your comments and think I’m finally starting to get it. People can appeal the NCVIP decision in federal court, but since they’re appealing the original decision rather than suing the vaccine manufacturer, even if they win on appeal they’ll get compensated by the NCVIP, not directly by the manufacturer. Of course, the antivaxxers don’t like that because the idea is to “punish” the vaccine manufacturers for “injuring” their child. So, aside from the fact that their argument hinges on the erroneous belief that the threat of being sued by angry parents is all that’s keeping big bad pharma from making vaccines out of rat droppings, they’re basically correct in saying that vaccine manufacturers can’t be sued – or at least not for vaccine injuries?

Apparently vaccine manufacturers can still be sued for things like fraud, so I assume that if someone actually had evidence that, say, vaccine manufacturers knew that vaccines cause autism and deliberately hid that info (a la tobacco companies or the Ford Pinto incident), they could be either sued or charged with the relevant crime (right?) Of course, the antivaxxers have no such evidence, but they seem to think the fact that their child suffered x ailment after a vaccine should be considered adequate in and of itself to prove that the vaccine manufacturer did something wrong.

But what about a vaccine injury that was obviously caused by an avoidable mistake on the manufacturer’s part, like the Cutter incident, for example? Would the parents still have to go through the NCVIP, or is this a case where they could sue the manufacturer via the tort system?

I appreciate you taking the time to try and explain this stuff to me, BTW – just let me know if I’m getting on your nerves.

Vaccinated children are susceptible to chicken pox as well. If they weren’t, you all wouldn’t mind so much if there were non-vaccinated children around your own kids, or more so, ill children with the disease.

Sober people get in car crashes too, so why should you mind if there are drunk drivers on the road when you’re driving your kids to school?

The point I would like to make is that if something carries a risk, everyone deserves a choice.

You have a choice – no one is going to break down your door and vaccinate you or your kids. You just don’t like the fact that your choice has consequences – you want the benefits of living in a society without the reponsibilities.

The point of contention is how often those side effects happen. We don’t need to argue about that, suffice to say that we differ in opinion there.

Cliche but true: You’re entitled to your own opinions but not your own facts. Seat belts carry a risk, but we still make people buckle up their kids because the benefits of wearing a seat belt outweigh the risks by such a large margin that it’s considered negligent not to do so. The fact that some people think that seat belts cost more lives than they save is irrelevant – the objective fact is that they’re wrong.

We don’t need to argue about that, suffice to say that we differ in opinion there.

Except opinion is not how these things are decided. And years of clinic trials, epidemiological studies, and post market surveillance tells us that severe reactions are vanishingly rare.

When someone has cancer and there’s a 99.99% chance that a surgery will successfully remove it, the patient and/or the family is given a choice.

No one is forcing anything on adults*. You free to not vaccinate yourself. It is different when it comes to children.

The government has a responsibility to protect children. In your scenario, if the family chose to forego surgery there’s a good chance the state would attempt to take medical custody of the child. You can’t just let a child die because of philosophical objections to surgery. Likewise you should not be allowed to let a child suffer and spread VPD’s because of irrational fear.

It doesn’t matter that you think you are acting in your child’s best interest. What matters is, based on the best available evidence, what actually is the best for your child.

*Despite what your ilk claim, no one is forcing anything on children either. There will just be consequences for your actions. Actually here there aren’t even any consequences, merely an additional minor inconvenience.

But what about a vaccine injury that was obviously caused by an avoidable mistake on the manufacturer’s part, like the Cutter incident, for example? Would the parents still have to go through the NCVIP, or is this a case where they could sue the manufacturer via the tort system?

Fair game. IANAL. Neither is Dorit, but I have an airport van coming in seven hours, the water in the building is going to be shut off in five, and I wasted two searching for the key to the laundry room, so – if it hasn’t been mentioned already – I’ll just leave this here.

The nearest thing we have in these here parts is the Raskalnikovs, who sing doleful existential lyrics that might have been written by Dostoyevsky and Leonard Cohen collaborating while on a ketamine bender, all in a fake drunken-Russian accent, with accordion and violins. Though the ‘drunken’ part might not be faked.

Not just the ones with compromised immune systems or egg allergies or whatever. There’s a small percentage of people for whom this or that vaccine doesn’t work: it doesn’t provide immunity. This is no different to anything else in medicine: no preventive or treatment measure is 100.000% successful. But the only way to find out who these kids are, who got their shot but didn’t develop immunity, is to run expensive tests on all the kids. (Are you willing to support a tax increase to pay for that?)

Now you have an outbreak, and somewhere in your school district are a handful of kids who couldn’t get vaccinated for medical reasons, and a handful of kids for whom the vaccine didn’t work. If herd immunity levels are high enough, the chances of any of those kids coming into contact with a contagious case are next to nil. But if you have enough philosophical exemptions in the mix, herd immunity is broken, and the probability of those kids who have medical exemptions or for whom the vax didn’t work, coming into contact with a kid who’s contagious, skyrockets.

This is something a lot of people don’t understand: herd immunity is a threshold phenomenon. At one level of community immunization, herd immunity is intact and diseases don’t spread. At a very slightly lower level, herd immunity is broken, and outbreaks occur. Think of it like dominoes: there’s a critical distance of separation between them, that prevents them all tipping over in a row. A small fraction of an inch makes the difference between one domino tipping another, and not doing so.

The difference between intact herd immunity and broken herd immunity is a couple of percentage points, usually less than the percentage of people who are seeking philosophical or other belief-based exemptions. If we allow all of those exemptions, not to mention the lazy ones from parents who just can’t be bothered, then what we have is broken herd immunity, and a population in which an outbreak can occur.

All for the sake of parents avoiding a “risk” that only exists in their minds.

So I have a question.

It’s WW2 and there’s a draft on, to fight the Nazis. If your kid gets drafted, he (it was only “he” in those days) has a decent probability of coming back wounded or suffering PTSD (“shell shock”) or coming back dead. What are you going to do? Try to duck the draft?

In fact what happens is that the draft boards allow committed pacifists to do alternative service, most of which also has personal risks (e.g. fighting forest fires while the regular firefighters are fighting Nazis). And the draft boards allow medical exemptions as well. But they have to count on getting enough young men into uniform to constitute a viable fighting force to defeat the Nazis.

So what are you going to do? Try to arrange for your kid to duck the draft? Because “nobody should be forced to (blah blah blah)…”? Because “risk”…?

Tell you what. Go watch The Man In The High Castle. Watch a couple of episodes. Think about living under a Nazi regime in what used to be the United States of America. Ask yourself whether it was worthwhile keeping your kid out of a uniform.

And then go read up on the pandemics that used to break out before vaccination.

The “risks” of vaccination are infinitesimal compared to the risks of going into combat.

There are times and places and issues where every civilized society must require its members to put the common good ahead of their self-interest. Fighting Nazis was one of those. Fighting measles, whooping cough, diphtheria, polio, smallpox, chicken pox, etc., is another. BTW, chicken pox sores in the emerging post-antibiotic world, are probably a risk of dangerous secondary bacterial infection.

But if there was a world war going on right now, it would make all this stuff about the “risks” of vaccines seem utterly pathetic by comparison. And guess what? It’s utterly pathetic by comparison to the risks of epidemics of dangerous diseases. Just be glad there isn’t a military draft, OK?

Where do you see that the waiver rule is actually bringing waiver numbers down? I cited a source. Where’s yours?

Actually, your source doesn’t say anything about whether the waiver rule is working or not. All it says is it’s too soon to know for sure. This article notes that compared to last year, waivers in Okaland County are down from 4,400 last year to 2,000 this year. It also notes that it’s too early to tell, but these numbers suggest that it could be working.

I don’t think I understand your concept of a “susceptible” child.

For the purposes of the school setting, a susceptible child is one who is either known not to have immunity (clear record of no immunization/previous infection) or has no record of immunity (they may or may not have been immunized or previously infected, but there is no record at the school). Someone who has been vaccinated is considered “not susceptible” (again, only so far as school exclusion during an outbreak is concerned).

You do know that every child is susceptible to these illnesses right?

That is not true. The majority of children who are vaccinated will not be susceptible. Yes, there will be some who are, just as there are some who are susceptible even though they’ve had the disease previously. But for the most part, if a child has been immunized or previously had the disease, they will not be susceptible.

Vaccinated children are susceptible to chicken pox as well. If they weren’t, you all wouldn’t mind so much if there were non-vaccinated children around your own kids, or more so, ill children with the disease.

You seem to be arguing that vaccines are either 100% or 0% effective, with no in between. That’s not the case. Depending on the vaccine, efficacy ranges from ~80%-99% effective. Because there are people for whom the vaccine doesn’t produce immunity (not to mention individuals with real medical contraindications and are thus at increased risk of infection), we want to make sure that the risk of an outbreak is as low as possible.

Logically, if you’re worried about incubation times when a so-called preventable disease is exposed in a school, then EVERY child should be excluded for those 21 days.

You appear to be assuming that every vaccinated child is 100% susceptible to infection, when that is not the case. There will be a large percentage of vaccinated kids (and those who have been previously infected) who will be immune. By excluding those kids who are susceptible to infection out, the school decreases the chances that the viruses/bacteria will find new hosts and continue to spread. There may be a handful of new cases among the presumed immune, but that will be a much smaller amount than if all of the susceptible kids were present.

Even if your own logic held true and vaccinated children had a slightly lower incubation period than nonvaccinated children, then they should be excluded from school for 19 days and the vaccinated children excluded for 21 days.

Vaccinated kids don’t have a lower incubation period. They have no incubation period because they don’t get infected to begin with. When exposed, their bodies are prepared to fight off the pathogen before it can get a foothold and begin incubating. The variation in incubation times I mentioned is among those who do get infected, and that’s due to individual biology, amount of exposure, etc. For purposes of exclusion from school, the greatest amount of time for the incubation period is used to ensure that the last case is really and truly no longer infectious.

Furthermore, even the CDC, FDA, and vaccine manufacturers admit that there can be severe and devastating side effects.

Yes, and? The rate is orders of magnitude lower than serious complications from the diseases that they prevent.

The point of contention is how often those side effects happen. We don’t need to argue about that, suffice to say that we differ in opinion there.

Thankfully, we have scientific evidence, rather than opinion, on which to rely.

The point I would like to make is that if something carries a risk, everyone deserves a choice. When someone has cancer and there’s a 99.99% chance that a surgery will successfully remove it, the patient and/or the family is given a choice.

First off, you have a choice. No one is forcing you to vaccinate your child. But, as with all choices, what you decide to do determines what outcomes follow. You can choose to drive drunk at 90 miles an hour in a residential area. But that might lead to losing your license, hitting an object, hitting another person, injuring yourself, etc. But you have that choice. Second, if a child has a cancer that has a 99.99% chance of being cured through surgery and the family chooses not to undergo that surgery, there is a very high chance that the state will step in, take medical custody of the child, and order the surgery to go forward, because the parents are not acting in the best interests of their child. The same is not true for a competent adult. If an adult decides they’d rather let the cancer progress and kill them, that’s fine, but the state has an interest in ensuring the welfare of vulnerable populations who are incapable of making such decisions on their own. It’s more complex than I have space to go into.

I don’t want to persuade anyone else not to get vaccines. That is absolutely your choice. And I wish you well. I would just like to have the same consideration given to me.

Good that you don’t want to persuade others not to get vaccinated, because if you did, you would be putting even more people at risk than simply keeping your decision not to vaccinate to your own family. However, the reason that I do try to persuade people to vaccinate is because 1) I don’t want their children to suffer from these diseases and the complications that come with them and 2) I don’t want their children to spread these diseases to other people, such as those who have suppressed immune systems due to disease or medical treatment (e.g., cancer treatment, transplant recipients on immunosuppressant therapy, and so on). Many of those people have a higher chance of death or serious, permanent injury from a disease that might mean only a week or so off from school for someone else.

You seem to be arguing that vaccines are either 100% or 0% effective, with no in between. That’s not the case.

Yes, this is typical of antivaccine thinking: If vaccines aren’t 100%, then they’re crap, completely useless. Antivaxers are not known for appreciating nuance or shades of grey. They kind of remind me of this: https://youtu.be/seN7AKSwMFU

Even before the rule change, exemptions were not the “easy, lazy” way to go. 99% of the time we still had to listen to doctors, friends, and family member lecture us. Doctors would take forever to get the waiver form, making us wait extra time. Schools and daycares would misplace those forms and we’d have to jump through hoops to get them. It’s only slightly more annoying now than it was before, except the major difference is the amount of money being paid by the taxpayers to fund this rule program.

Oh, you poor brave thing, having to endlessly defend your hip Mama transgressive choice to all and sundry. It’s not like those people even care, or have done their research.

Why didn’t you just hide in the herd? But that just wouldn’t be as cool, would it? This is SUCH a great way to flaunt your privilege.

Something about Maria’s description of getting a waiver rang hollow to me, so I took a look about and managed to find the older immunization waiver form (the one in use before the new rule requiring parents to attend an educational session) online (PDF via the Traverse Children’s House). So a few things:

1) I found it easily online. No need to go to the doctor to get it.
2) There is no space on the form for a doctor’s signature, so it can be completed by the parent alone.
3) Schools and day care centers also lose immunization records, so even parents who choose to protect their children have those hurdles to go through. It’s not unique to non-vaccinators.

So, yes, it was very easy to get a waiver before. All you had to do was get the form (either print it from an online source or get one from the school, doctor’s office, or local health department), fill it out and send it to school with your kid. That’s it. Really quite easy.

The point I’m making about the old form, Maria, is that compared to actually getting an immunization, it was much, much easier. With the new rule in place, it is at least closer a burden to get a waiver as it is to get the vaccinations, meaning that for it’s mainly going to be die-hard anti-vaccine folks who will be getting the waivers, not the fence sitters, hesitant or lazy parents.

Ideally, states should make it as easy as possible for parents to get their kids immunized.

I thought Gray Squirrel was going to make a nice quantitatively informed argument, but unfortunately it devolved into some hodgepodge of moralizing involving Nazis and draft-dodgers. Which illustrates what I think is the problem here, and relates to my recent comment on the “Reiki will destroy us all post.”

These are mundane, pragmatic issues . There is no grand overarching principle that you are applying consistently, and there is no real existential threat, and so all the self-righteous indignation and “think of the children” hyperbole is just as foolish as that of the “other side”.

First, let me stipulate that I argue for vaccinations to be given free to children through the school system, as a community activity and social good.

Now, let’s try a simple hypothetical. What if, (given current policy), the number of students with medical exemptions exceeds the threshold for maintaining herd immunity?

What should be done? Should they all be banished to the home schooling wasteland? Some of them? Who chooses? What principle is controlling?

I’m glad to hear that you are out and about.
I never heard of that group before- the guitar dude is quite expressive, isn’t he?

I spent an hour or so yesterday listening to excellently swirling, hypnotic music whilst eating in a restaurant in the Muslim “quarter”- ( no, I’m not in Jerusalem)- trance has nothing on them!. The servers were too busy for me to ask about their sources though.

@Maria,
Risk assessment is something you might want to study. As Todd and others have already pointed out, there are risks to vaccinating and there are risks to not vaccinating. Those risks are NOT equal.

Something about Maria’s description of getting a waiver rang hollow to me, so I took a look about and managed to find the older immunization waiver form (the one in use before the new rule requiring parents to attend an educational session) online (PDF via the Traverse Children’s House). So a few things:

I’m sure she’s conflating the legal requirements for a waiver back then (just sign a form and give it to the school) with the social disapproval of her choice. Either that, or she was too clueless to find the form online, even though it was easily locatable on the Michigan Department of Community Health Website and various antivaccine websites that hosted PDFs of the form because, well, they’re antivaccine sites.

Now, let’s try a simple hypothetical. What if, (given current policy), the number of students with medical exemptions exceeds the threshold for maintaining herd immunity?

What should be done? Should they all be banished to the home schooling wasteland? Some of them? Who chooses? What principle is controlling?

Your hypothetical hyperbole misses the point, zebra.

According to the “current policy” in the event of an outbreak, the school would inform the parents and try to minimize the spread, possibly by asking those sick, and those with elevated risk (e.g. children with medical exceptions) to stay at home for the duration of the outbreak. Not indefinitely, like your hyperbolic JAQing off suggests you assume.

“But you think your Magikal Breastmilk is a lot more protective than it is in reality. And you gotta be immune yerselves in order to confer any form of immunity to your snoflake.”

I can’t understand where this Breastmilk Confers VPD Protection thing came from. IgGs are transferred via placenta, so a mum who’s up-to-date on vaccines and boosters will pass temporary immunity on their baby no matter how it’s fed. Breastmilk has some IgA in it, which has moderate protection against some minor GI ailments but no protection against VPDs. So get your kids vaccinated, even if you’re one of those Kewl Moms who lets nothing but mom’s milk right from the tap pass your kid’s lips until high school.

I spent an hour or so yesterday listening to excellently swirling, hypnotic music whilst eating in a restaurant in the Muslim “quarter”- ( no, I’m not in Jerusalem)- trance has nothing on them!. The servers were too busy for me to ask about their sources though.

One of my favorites along those lines is Sufi singer Nusrat Fateh Ali Khan. I first heard him in a sari shop in Leicester UK (long story culminating for another time), did have time to ask, headed for the closest Asian music store, which was pretty close in Leicester, and bought the eponymous album that contains this track 🙂

Troll the Teabagger boards with posts depicting VPD germs as unwanted alien immigrants, or biological terrorist refugees, and immunization as the wall to keep America safe. Suggest that anti-vaxers are being manipulated by ISIS, and the bill’s sponsors are getting hushed campaign funding from front groups laundering money from Saudi Arabia. Get the NRA fans motivated to participate in defending the security of the schools against those who would open them to microbe invasions. If the Michigan Department of Public Health is barred from keeping un-vaxed kids out of school, let’s see how their subversive parents like marching their pestilent snowflakes through a gantlet of Michigan militiamen armed with AR14s!

So, aside from the fact that their argument hinges on the erroneous belief that the threat of being sued by angry parents is all that’s keeping big bad pharma from making vaccines out of rat droppings, they’re basically correct in saying that vaccine manufacturers can’t be sued – or at least not for vaccine injuries?

I might have missed it, but I didn’t see this answered.

You can still sue the manufacturer for an injury. However, you can’t be claiming it was due to a design defect. Design defect claims go to the NVICP. But if you are alleging it was caused by manufacturing errors, fraudulent substitution, or something along those lines, then you absolutely can still sue. So if the vaccine is labeled “MMR” but actually contains rat droppings, then you can sue the living snot out of them. 😉

I can’t understand where this Breastmilk Confers VPD Protection thing came from. IgGs are transferred via placenta, so a mum who’s up-to-date on vaccines and boosters will pass temporary immunity on their baby no matter how it’s fed. Breastmilk has some IgA in it, which has moderate protection against some minor GI ailments but no protection against VPDs. So get your kids vaccinated, even if you’re one of those Kewl Moms who lets nothing but mom’s milk right from the tap pass your kid’s lips until high school.

Well, because breastmilk is the panacea for just about everything that ails a child. Baby got otitis media? Squirt some breastmilk in that ear. Conjunctivitis? Whip out the girls and aim for baby’s eyes.

According to the “current policy” in the event of an outbreak, the school would inform the parents and try to minimize the spread, possibly by asking those sick, and those with elevated risk (e.g. children with medical exceptions) to stay at home for the duration of the outbreak

I believe it’s two infection cycles after the last case. Sucks to have an anti-vaxxer parent.

Read the question again. Carefully. Where does it mention “outbreaks”?

…aaaaand zebra proves my point about hyperbole.

So your hypothetical was that should there be enough medical exceptions to threaten herd immunity, they would all be “banished to the home schooling wasteland”.

Which is a ridiculous assumption nobody is suggesting. Hence, me calling your idea a hyperbole.

Maybe you just need to pay attention before your knee jerks?

Indeed, right back at you. Unless your “given current policy” was a code for ‘situation unlike real life’, nobody forces kids with medical exemptions to be home schooled under current policies unless there is an outbreak.

Right, those date-filled mamoule were spectacular. I believe that that 100 g misunderestimated the amount I bought- more like 200. The proprietor had 40 types of small pastries with almonds, pistachio, sesame, dates, cheese etc.

Interestingly, I seem to manage many free samples and free beverages in these shops / restaurants.
Despite my infidelity.

In one of the recent local MI articles, the journalist thoughtfully included a link to an interactive db that could be queried by school, by city and so on. It was very helpful in demonstrating the geographical clustering, also the quasi-religious effect of Waldorf-Steiner schools. IIRC, there were a worrisome 18 schools with 100% waivers, and a troublesome amount around 50% (not that the ones between 50 and 95 were doing any better). Thanks, crunchies and freedumb-advocates.

I’m going to assume you really do have some problem with reading comprehension and aren’t just being a jerk.

“What should be done? Should they all be banished…?”

Is a question, not a conclusion about what would happen.

As a social policy, how would you handle that hypothetical (but not impossible) situation where medical exemptions threaten herd immunity? Is that really hard to understand?

And I’d certainly like to hear from Gray Squirrel on this since it was his reply to Maria which motivated the question. Before it got into tv shows about Nazis, it was an interesting formulation, which illustrated some of the valid points in Maria’s position.

You can assume whatever you want about me, but JAQing off like you did is so common and loaded tactic – implying your should we’s were valid options. But the truth is, nobody here (apart from you with the said questions, or in the fever dreams of antivaxxers) is suggesting we banish kids with medical exemptions from public schools.

I also like you describing my “there would be no problem, situation as usual” as a unreasonable knee jerk reaction.

There are whole countries on this planet with insufficiently high vaccination rates for effective herd immunity. There are scores of transmittable diseases without vaccines. Yet unvaccinated are allowed in public. If you think this is somehow about to change, I’d like to hear your reasons why, and how, rather than try address your own straw men with silly questions.

Now, let’s try a simple hypothetical. What if, (given current policy), the number of students with medical exemptions exceeds the threshold for maintaining herd immunity?

What should be done? Should they all be banished to the home schooling wasteland? Some of them? Who chooses? What principle is controlling?

Since in Michigan only 0.3% of children have medical waivers with the other 99.7% made up of religious and philosophical waivers. I don’t think medical waivers are going to increase 18-fold (to the 5% required to threaten measles herd threshold) and threaten herd immunity. I think it is religious and philosophical exemptions that are the problem.

I just did make my point– you aren’t going to answer the question, because the answer might illustrate that there is some validity to the questions raised by Maria, and to which GS was trying to respond.

Todd W @ 148: Excellent point. Make it more difficult to get exempted than to get immunized, and more people will opt to get their kids immunized.

There is a large subset of the population for whom “easy” is the governing value, regardless of whatever rationalizations they claim. For modern humans, “easy” often translates to “time required to complete task” rather than to physical exertion or mental effort.

It might be interesting to compare caloric expenditure along these three axes of measurement. I would hypothesize (and this should be testable) that a consistent percentage of humans has an internal heuristic for “effort” that is largely based on “time on task,” correlates with caloric expenditure, and makes behavioral choices based on that.

Zebra @ 149: Sorry to disappoint.

I don’t have the academic background nor the access to the peer-reviewed literature, to produce a table of statistical values for herd immunity and the breakage thereof. But in any case, that line of arguement is hardly persuasive with people whose reasoning is clearly based on subjective emotional weightings.

Moral hodgepodges (or did you say “hedgehogs”?;-) are more persuasive with people whose center of gravity is subjective rather than objective. That’s true whether any of us like it or not. If you failed to see the obvious connection between compulsory military service and the way a segment of the population views “compulsory” vaccination, I can’t do much to help (maybe tech support is open at this hour?).

Sadmar @ 163: Brilliant.

YES we should. What you said. I’d stop at the “enlist NRA” part, but the rest of it is excellent. (Sorry you don’t like that one either, Zebra, I’d seriously suggest taking some OTC humor pills, for example M&Ms or something else with chocolate as the active ingredient.;-)

Zebra @ 184: What to do when medical exemptions threaten herd immunity:

I’m not aware of any actual instance where that has occurred. But if you had a school district where that was the case, the only thing you could do is keep all those medical exemption cases home for the duration. Any such school district should be prepared for that contingency by having sufficient “distance learning” technology in place and ready to use. For example:

A district-wide website in which every student was automatically enrolled and given a browsermail address. In an outbreak, classroom materials, homework, and tests, would be conducted via the website. Poor families would get free basic laptops designed to interact primarily with that website and with other whitelisted sites. A teleconference bridge or contract with a teleconference service, so students who needed to access classes via telephone rather than computer (e.g. families without decent broadband service) could do so. An arrangement with the local cable TV provider’s public access channel for immediate pre-emptive usage during an outbreak. A community volunteer service organized on a neighborhood basis for assisting students who need technical or other support.

Thus in the event of an outbreak, the vulnerable kids all stay home but continue to participate via distance learning until it’s safe to resume going to classes. This shouldn’t be extended to provide a means of enabling antivaxers to demand that it be used so their snowflakes could gain any sort of advantage.

And even though you didn’t ask, I’d say that as a matter of law, staying up to date on immunizations should be a condition for obtaining a driver’s license or state ID card. And that the fed gov should enforce this by way of withholding federal funding for local schools and transportation projects, from states that don’t comply.

Between the anti-vaxers, AB resistance, newly-emerging diseases, microbial migration due to climate change, and yes the threat of bioattacks (that’s not paranoia, go see what the Pentagon has to say), etc., we are now in a whole new world as far as policies related to infectious diseases are concerned.

I actually thought the military draft analogy is useful as a way to examine social policy. I don’t happen to agree with how you are moralizing about it though.

And my question, to make it clear yet again, refers to normal conditions not outbreaks. Just, at the start of the school year, we discover that there are too many medical exemptions to maintain herd immunity.

So I will take your answer and apply it to that situation. You are saying that we should in fact prohibit those students from attending, but provide some resources to facilitate their education. Again, this would be a long term situation, not for some short period while there is a specific outbreak.

I’d like to comment further on the draft analogy, but I want to be sure there is no misunderstanding up to this point.

I just did make my point– you aren’t going to answer the question, because the answer might illustrate that there is some validity to the questions raised by Maria, and to which GS was trying to respond.

In some kind of warped alternate universe you might have point but here you don’t. You didn’t present a realistic hypothetical so how can your questioned be answered realistically? As Krebiozen said, it is the non-medical exemptions which erode herd immunity threshold.

So I will take your answer and apply it to that situation [non-outbreak, start of the school year]. You are saying that we should in fact prohibit those students from attending, but provide some resources to facilitate their education.

And here we see an example of why it’s silly to engage zebra. After complaining about how other people seem to have trouble understanding its brain droppings, it builds up a strawman, claiming that someone said something they never said.

Not sure how you could have that many medical exemptions that your percentage of vaccinated school children is below herd immunity given that Mississippi and West Virginia have only 0.5% of school children not fully vaccinated–and those can (because of their state vaccination laws) be the ones with a valid medical condition for being unable to receive vaccines.

I normally don’t reply to zebra, but since the question has been answered, I’ll make it simple for him to read it:

zebra: Just, at the start of the school year, we discover that there are too many medical exemptions to maintain herd immunity.

RI regulars: Yes, they should be allowed to attend school, even if there are too many medical exemptions to maintain herd immunity.

Now, zebra, explain to us how you can get so many hypothetical *medical* exemptions in one area that it would impede herd immunity, given in states where only medical exemptions are allowed, they only comprise about 0.5% of the population.

I normally don’t reply to zebra, but since the question has been answered, I’ll make it simple for him to read it:

zebra: Just, at the start of the school year, we discover that there are too many medical exemptions to maintain herd immunity.

RI regulars: Yes, they should be allowed to attend school, even if there are too many medical exemptions to maintain herd immunity. However, the district will need to keep this in mind in case of any infectious outbreak, and have plans for distance learning if quarantine needs to be established.

Now, zebra, explain to us how you can get so many hypothetical *medical* exemptions in one area that it would impede herd immunity, given in states where only medical exemptions are allowed, they only comprise about 0.5% of the population.

You are willing to put the vulnerable members of the school population at risk by compromising herd immunity.

That’s all I wanted to know.

So, firstly, you did continue with the trusty zebra tactic of ignoring questions.

Secondly, I said exactly this in my first, i repeat, first, reply to your silly hypothetical. I mean, honestly, go read it. Number 153.

I’ll retype it in simplified logic for you.

If [outbreak], initiate [safety protocol].
Else, continue life.

That reply was simple enough that the fact you failed to understand reflects on you, not me.

Thirdly, no, I’m not.
There are other options to limit the danger of contagion than blanket bans, which – in the case of such high numbers of vaccine exemptions – I would assume the school, parents, medical centers and the government to take. Many of these options are already in use, with seriously immunocompromised children (among others). These would include distance learning and staying at home if there is an outbreak elevated danger of contagion.

And even without such measures, I would not vote to banish them permanently.

I believe what the striped beast is trying to imply is that there is no moral justification to exclude one group who doesn’t vaccinate (religious/PB exemptors) but allow a different group who doesn’t vaccinate (medical exemptors) if the amounts of both would jeopardize public health. In short, it is arguing that we have a double standard.

@zebra: Yes, it matters because in reality only about 0.5% of all people need medical exemptions, well above the number needed for herd immunity. So if we have that hypothetical number of people needing medical exemptions, we have bigger health problems than VPDs to worry about.

So yes, the risks ARE different between those who are vulnerable and those who are just lazy/uneducated/careless.

Worrying about medical exemptions compromising herd immunity is like worrying about how I’ll keep my basement dry if the Minnesota River floods all the way up to my house. I live about 350 feet above the river’s normal level, so if that were to happen a dry basement would no longer be a priority for me as I would have other problems.

Medical exemptions are only viable if there aren’t very many of them. If the number rose as high as you propose, zebra, we would no longer be able to sustain an eradication program for the disease in question. (Remember, medical exemptions are seldom blanket. They are pertain to specific vaccines, not the overall concept of vaccination. And different diseases require different vaccination rates to achieve herd immunity.)

Which vaccines are made mandatory for school entry depends on several things (in no particular order):
1) infectiousness
2) odds of an outbreak
3) risks associated with the vaccine
4) effectiveness of the vaccine

If the vaccine is very risky, which is what it would have to be for your hypothetical situation to occur, then it would not be put on the schedule because it wouldn’t be feasible to get herd immunity with it. If it’s not a disease the school is likely to encounter, that also reduces the motivation to put it on a schedule. Consider the vaccines against tuberculosis and yellow fever. Neither are currently on the required list for school entry, because there isn’t enough reason to require them. Sure, it’d be nice to keep TB out; it’s a nasty disease and definitely communicable in an instutional setting. But the vaccine is a little unfriendly, and it messes up TB tests, and it doesn’t look likely we could get herd immunity against it anyway.

So in your hypothetical, that vaccine would not be a good choice to require for school entry. It would do more harm than good. It could probably stay on the CDC’s recommended list, though, if it’s still got enough value to the individual to get it.

Zebra: Not MIDawn, but I know this one….See, kids without a medical exemption can be vaccinated, assuming that the legal system can override the parents.
They also don’t have the same risk of dying as the kids with the medical exemptions run, because some of those medical exemptions are rather serious, like say, having a transplanted organ or having leukemia.
Frankly, I’m beginning to wonder if Michigan even wants medical care. Maybe the doctors and hospitals could be parceled out to more deserving states.

The troop of monkeys that spends its time on the internet agreeing with each other on how that other troop of monkeys is lazy, uneducated, and careless, tells me that I live in a bubble and don’t deal with reality.

I believe what the striped beast is trying to imply is that there is no moral justification to exclude one group who doesn’t vaccinate (religious/PB exemptors) but allow a different group who doesn’t vaccinate (medical exemptors) if the amounts of both would jeopardize public health. In short, it is arguing that we have a double standard.

I believe you hit the nail smack dab on the head.
@zebra, you are JAQing off. The likelihood of medical exemptions reaching a level sufficient to jeopardise herd immunity is as likely as new research finding that vaccines actually cause autism. i.e. slim to nonexistent.
A hypothetical argument is just that: hypothetical. We can discuss what the world should do if an E.L.E sized asteroid was detected heading towards Earth, but unless and until this scenario arises, we can’t use that scenario to criticise current policies.

ToddW: You beat me to it. PGP, you need to drop the whole “take medical care away” nonsense. It’s incredibly offensive and doesn’t help at all.

I don’t see how it’s offensive. If people think they know better than the medical professionals, maybe they should be called on their bluff. Also, may I remind you that the USA has an extremely limited supply of money and professionals. If services in a given area aren’t being used and are putting the professionals that offer them in danger, rather than wasting time on changing people’s minds, the services should be diverted to areas where they will be used and appreciated. And maybe, someday, the affected area might learn to appreciate those services and clamor for them again.

I don’t see how it’s offensive. If people think they know better than the medical professionals, maybe they should be called on their bluff.

So because a small percentage of people in Michigan refuse to follow vaccination advice, a percentage so small it is outnumbered significantly by those who do follow the vaccination schedule, you would take medical facilities available from everyone in Michigan?
If you don’t realise how foolish and wrongheaded this is, i can’t help you.

If services in a given area aren’t being used and are putting the professionals that offer them in danger, rather than wasting time on changing people’s minds, the services should be diverted to areas where they will be used and appreciated.

So you want to punish the 95% of Michiganders who do vaccinate their children because 5% do not? That seems a little unfair.

“Perhaps we should do an *RI Greatest Hits* of loonies and other creatures?”

Oh, please, YES!!! Especially the ones who are simply too dense to realize how dense they really are. Like when the holes in their arguments are pointed out, yet they keep diggin’ that ol’ hole deeper and deeper, smugly believing that they are putting us in our place, but – really – just causing great hilarity.

I suppose that those of us who have especially vivid memories of interactions with them could write up for general instructional purposes as well as entertainment.

So let me begin:

How well I remember…
JAKE
who argued with me about how autism was caused by mercury, how psychologists were basically [email protected] and how Andy could do no wrong. Then, he responded unrealistically to my questions about how he could hold such unlikely conspiracy theories and how he didn’t feel that his internet activities and general contrarianism would deleteriously affect his future employment prospects.
He was at the time, a new college graduate just prior to his adventures in Public Health Science.

JF/Kreb:So because a small percentage of people in Michigan refuse to follow vaccination advice, a percentage so small it is outnumbered significantly by those who do follow the vaccination schedule, you would take medical facilities available from everyone in Michigan?

The problem is that it’s NOT a small percentage. Perhaps you missed the bit in the article where Orac mentioned that every single state representative in Michigan is an anti-vaxxer? And that therefore, their constituents are anti-vaxx.

I didn’t say that every state representative is an antivaxer, just that the legislature has been taken over by Tea Party types, a significant number of whom seem to view vaccine mandates as an unacceptable restriction on their freedom, which makes them susceptible to antivaccine dog whistles.

Politicalguinepig, do you even math?
Let’s take Krebiozen’s number as representative. In fact, let’s be generous and assume 6% of children have vaccination waivers. That means that 94% are up to date on their vaccinations. Now…
94/6 = 15.666. That means that for every exempted child in Michigan, there are 15 children who aren’t exempted.
Do you now see how silly your comments look?

PGP, as we’ve explained to you time after time after time, you engage in exceedingly broad brush strokes way beyond what the evidence suggests, you propose extremist solutions to issues, and you read into others’ comments things they never said. You do far more to polarize and alienate than you do to help.

PGP: You are advocating collective punishment. Specifically, you’re calling for a policy designed to kill innocent people, including children, because you dislike their parents or neighbors’ political opinions.

Suppose we have a country where there are pockets of anti-vax mania- these parents are very vocal, enjoy natural medicine, join various advocacy groups and pester their legislators. They love exemptions and use them generously.

Occasionally, a VPD will flare up in these environs, sickening many children.

HOWEVER the majority support vaccination and send representatives to the Capitol City. One of them introduces a law to tighten up exemptions.

A war of words erupts and the anti-vax contingent send in their own best people to battle it out. The proposed law and its originator are reviled and protests ensue.

The vote is taken and the new law is passed. The opponents shriek on ceremoniously, blogging and tweeting, issuing facebook fatwas and threatening their opponents. BUT they are a minority with very big mouths and numerous twitter accounts.

So the law stands. Children need to be vaccinated unless there is a medical issue. No one is forced into anything and no one is denied services ( as if that would be easy to implement).

-btw- It’s all true. It’s called California.

Should parents support SBM be punished because they live near a wretched ( dry) swamp of science-deniers in San Rafael, Santa Rosa or Santa Monica? Even those places do not have a majority of antivaxxers. A few altie schools may have a majority of un-vaccinated students but that’s not the majority of students.

Stop vaccinating Delphinette and she’ll cut you off at the knees. We met a real, live, non-vaccinating family tonight. Two parents at Delphinette’s school. Both chiropractors. I hadn’t eaten since breakfast and had nothing to drink since Sunday and their hubris was blindingly painful.

JF: Politicalguinepig, do you even math?
Let’s take Krebiozen’s number as representative. In fact, let’s be generous and assume 6% of children have vaccination waivers. That means that 94% are up to date on their vaccinations. Now…
94/6 = 15.666. That means that for every exempted child in Michigan, there are 15 children who aren’t exempted.
Do you now see how silly your comments look?

You and Kreb are both assuming those numbers are accurate. The problem is.. they aren’t. For every counted anti-vaxxer, there are ten that somehow just aren’t on the radar until it’s an election.

Vicki: No, it’s called streamlining. If enough parents in an area say ‘no thank you’ to vaccines why bother keeping the vaccines around when they could be doing good elsewhere? Does one just keep them on the shelf until they expire? Should a doctor just sit and twiddle their thumbs when all the parents in the area sneer and go to naturopaths? Ideally, yes, children should get medical treatment.. but the only way that seems possible is if they are separated from their parents.

You and Kreb are both assuming those numbers are accurate. The problem is.. they aren’t.

Those were the percentage of people with exemptions. In other words, an official document. So it almost certainly is accurate.

For every counted anti-vaxxer, there are ten that somehow just aren’t on the radar until it’s an election.

That assumption is dubious even on its face. SB289 passed despite a massive campaign against it. So anti-vaxxers set up a petition to get it revoked.
They obtained a little over half the signatures they needed. I would say that there is no “silent majority” among anti-vaxxers. Otherwise, the petition would have passed with ease.

Vicki: No, it’s called streamlining. If enough parents in an area say ‘no thank you’ to vaccines why bother keeping the vaccines around when they could be doing good elsewhere?

Okay, here’s my question. What percentage of parents refusing vaccines in an area is “enough parents” to warrant not having vaccines in said area?
You know the biblical story of the destruction of Sodom and Gomorrah? Well, before God makes the decision, he tells Abraham what he planned to do. Abraham then asks if God would “destroy the innocent with the guilty” and if he found 50 good men there, would he still destroy the cities. God replies “no”. Abraham then successively lowers the number of “good men” and asks God if he would still destroy Sodom and Gomorrah. Each time, God replies that he would save the cities for the sake of the good men there.
Others have pointed this out before PGP, but it warrants repetition: you are proposing collective punishment just because a minority is stupid.

@ PGP
On one hand, I tend to like you, on the other hand not so much, especially when you do math about anti-vaxers.
I’m not an expert in US politics, but I think there are just 2 parties. So if you agree mostly with Republicans, you might vote for them, even if they might have some issues with freedom of vaccination. Some of them even may be anti-vaxers, others are just into individual choice and less government.

I live in a country with far more parties.. I don’t even know the exact number. We have something like 3 Christian parties, One animal rights party, One really right wing party, something like 3 or 4 left-wing parties and a bunch of others. I consider myself left-wing, but every left-wing party has some ideas I don’t agree with. So I have to vote for the party which might be closest to my ideas, which mostly is the green party. Yes, the have some alternative health proponents, but the alternative is a left-wing party which seems to like Putin a bit to much for my taste. Does my vote make me an anti-vaxer, or a proponent for alternative health? I don’t think so.

For every counted anti-vaxxer, there are ten that somehow just aren’t on the radar until it’s an election.

In Michigan last year 87.4% of children aged 19–35 months had received at least one dose of MMR*. It’s not as high as some other states, since I have relatives in Michigan, but it’s still the great majority of children. So unless these antivaxxers are in sleeper cells that are vaccinating their children to lull us all into a false sense of security, you are mistaken.

Please ignore the “since I have relatives…” part, which is the vestigial remnants of my original unedited comment.

Also, since I’m in errata mode, I mangled some editing in #187 which doesn’t change the gist of my argument but should have read:

In Michigan only 0.3% of children have medical waivers, that’s 6% of all waivers, with the other 94% made up of religious and philosophical waivers. I don’t think medical waivers are going to increase 18-fold (from 0.3% to the 5% required to threaten measles herd threshold) and threaten herd immunity.

Being punitive towards anti-vaxxers (because they are “lazy, uneducated, careless’, or just belong to the other monkey troop) runs the risk of generating this kind of extreme reaction.

Firstly, that’s a great example of the slippery slope fallacy. Secondly, your reasoning is flawed. Anti-vaxxers endanger those too young to be vaccinated, those who are immunosuppressed from cancer and organ transplants (or even other infections) and those who have genuine medical issues and can’t be vaccinated. That, and not your supposed reasons, is why we treat them with hostility.

I’m not sure how one can compare the protection of individual health (and the overall health of society – especially those who are too young or medically-unable to be vaccinated) to any sort of “punitive” or malicious actions…….

MI Dawn, speaking for the group, said that it would be an acceptable policy to go below the herd immunity level if the reason for exemption from vaccination is medical. Others (gaist at least I believe) overtly concurred.

(see #205)

So, the conclusion is inescapable. And supported by the tenor of many of the other comments with respect to anti-vaxxers.

Zebra, did you notice my response to you on the question of whether it would be acceptable to allow vaccine rates to drop below that needed for herd immunity if all the exemptions were medical ones? As it has had no response yet, I can only assume you didn’t.

My contention is that if a vaccine were so dangerous that greater than 10% of the population would qualify for medical exemptions, the appropriate thing would be to remove it from the list of vaccinations required for school entry. With one exception, school entry vaccination requirements exist to protect the student body, so if a vaccine isn’t capable in a practical way of achieving herd immunity, then it is not of interest to the school. Individuals may still want it for their own protection, but it isn’t a question of getting herd immunity anymore. So I’ve answered your question with a third option you had not considered: removing what is obviously a problematic vaccine from the school entry requirements.

The exception, by the way, is tetanus. It is not possible transmit tetanus. However, the tetanus vaccine is bundled with the diphteria and pertussis vaccines, and there is a significant liability concern if a child were to receive a puncture wound on school property. If the child is not vaccinated, then the school would be responsible for making sure the child got sent to a doctor in case of tetanus, and requiring the vaccine means they don’t have to do that.

Our stripey friend seems to live in a world of strictly black and white, while also positing ideas and positions that bear no relation to anything in the real world.

To repeat what was already posted above, if legitimate medical exemptions reached that point, then there would be something fundamentally wrong with the vaccine (or vaccines) – but since we know that doesn’t actually occur, because of the stringent testing and tracking of safety, this is nothing but another attempt to justify it’s own beliefs….

You are simply repeating the practice here of distracting from the question that I posed by talking about unrelated factoids.

MI Dawn 205 gave a direct and honest answer:

I normally don’t reply to zebra, but since the question has been answered, I’ll make it simple for him to read it:

zebra: Just, at the start of the school year, we discover that there are too many medical exemptions to maintain herd immunity.

RI regulars: Yes, they should be allowed to attend school, even if there are too many medical exemptions to maintain herd immunity. However, the district will need to keep this in mind in case of any infectious outbreak, and have plans for distance learning if quarantine needs to be established.

You can dance around the issue and spout factoids all day, but from this and the tenor other comments from various individuals, the animus towards anti-vaxxers is clear.

If children have medical exemptions from vaccines, they still should be allowed to attend school. In times of VPD illnesses, they need to be excluded *for their own protection* from school, and the schools need to have a plan for their continued education.

If the number of your hypothetical children with medical exemptions from 1 vaccine exceeds the number needed to promote herd immunity, then the requirements for that vaccine need to be reviewed as to the reason a)for the vaccine and b)for the exemptions and plans made to deal with the VPD outbreaks as noted above.

If the number of your hypothetical children with medical exemptions from all vaccines exceeds the levels needed for herd immunity for the VPD, then something is seriously wrong with those children and/or the community and it needs investigation. Again, plans for education during periods of VPD outbreaks need to be made by the district in advance so their education can continue.

Do you understand now why I agree with Lawrence and Calli? I’m sorry you didn’t understand my shorthand. Since the regulars here did, I doubt the fault is mine.

Oh, and as far as continuing education plans – in case zebra is unaware, most school districts do have educators who do home visits in cases of long-term absences from school. And, in today’s modern age, the schools could conceivably have laptops for all students and white board teaching for distance learning.

You are simply repeating the practice here of distracting from the question that I posed by talking about unrelated factoids.

But how is it unrelated? I am literally answering your exact question. Here is your original question:

Now, let’s try a simple hypothetical. What if, (given current policy), the number of students with medical exemptions exceeds the threshold for maintaining herd immunity? What should be done? Should they all be banished to the home schooling wasteland? Some of them? Who chooses? What principle is controlling?

I am directly answering that question, and explaining my reasoning. But since you are unclear, I’ll break it down for you.

What should be done? Remove that vaccine from the school entry requirements.

Should they all be banished to the home schooling wasteland? Some of them? Of course not. If the vaccine is no longer required, they’re free to attend school same as anyone else. They just have to stay home if they’re sick, which is how we treat everything other disease already.

What principle is controlling? Whether or not the vaccine can protect the student body. If you can’t get an acceptable level of herd immunity, then it isn’t worth requiring it (with the exception, again, of tetanus, which is a special case).

As I’ve said to others, increasing bits of information is simply a tactic to distract from the original point.

The part where you appear to be retracting:

If the number of your hypothetical children with medical exemptions from 1 vaccine exceeds the number needed to promote herd immunity, then the requirements for that vaccine need to be reviewed as to the reason a)for the vaccine and b)for the exemptions and plans made to deal with the VPD outbreaks as noted above.

Now, I said clearly and often that I am not talking about outbreaks. So we are back to that situation at the beginning of the school year. Are you still saying that the unvaccinated should be allowed to attend, if their numbers compromise herd immunity?

Among other things, you’re missing the difference between number of people and percentages. Suppose that only half the population of the county I live in were interested in getting proper vaccinations for themselves and their children. You would “streamline” by taking away their health care, assuming that the vaccines, antibiotics, etc. would spoil because the local doctors and hospitals couldn’t figure out how to order appropriate quantities for “only” one million people.

Conversely, I hope you wouldn’t refuse to ship vaccines to remote settlements because even 100% coverage is only a few hundred or even a few dozen people.

Believe it or not, epidemiologists and public health workers can do math. They know that 100 children need fewer doses of the tetatus or MMR vaccine than 100,000 children.

zebra #279:
Your little game is transparently obvious. You ask MI Dawn if children with medical exemptions should be allowed to attend school. She answers “yes” and makes clear that those conditions would be far below what the threshold to to endanger herd immunity.
You were asked to explain how allowing this would compromise herd immunity. What is your answer?
Instead, you pretend as if she said what you want to believe, with no basis in reality.
If you aren’t going to have an honest conversation, why are you here?

At the beginning of the school year, what do we do if there are too many exempted students to maintain herd immunity to *which specific VPD*?
The herd immunity levels are not the same for all diseases.

As has been said several times, herd immunity is only relevant when the disease is in play. At this time no school in America has herd immunity to smallpox. This does not matter, as smallpox is not in play.

And quite frankly, the only place you could describe with your hypothetical example is a pediatric cancer hospital, where quarantine is a constant condition. Therefore not relevant.

zebra #279:
Your little game is transparently obvious. You ask MI Dawn if children with medical exemptions should be allowed to attend school. She answers “yes” and makes clear that those conditions would be far below what the threshold to to endanger herd immunity.
You were asked to explain how allowing this would compromise herd immunity. What is your answer?
Instead, you pretend as if she said what you want to believe, with no basis in reality.
If you aren’t going to have an honest conversation, why are you here?

Apt summary for those playing along at home. Angus, thank you for saving readers a good half hour of wasted WTF time.

There would also be no outbreaks involved, so until zebra clarifies what he means by outbreak, we could just as well assume that the threat of the disease is 0, as we could assume an outbreak means a single person catching the disease, as per WHO’s A single case of a communicable disease long absent from a population […] may also constitute an outbreak.

As I’ve said to others, increasing bits of information is simply a tactic to distract from the original point.

This is one for the fυcking ages from the Zorse’s ass. Behold, the original “point” (omitting the snot-nosed introductory graf):

These are mundane, pragmatic issues . There is no grand overarching principle that you are applying consistently, and there is no real existential threat, and so all the self-righteous indignation and “think of the children” hyperbole is just as foolish as that of the “other side”.

First, let me stipulate that I argue for vaccinations to be given free to children through the school system, as a community activity and social good.

Now, let’s try a simple hypothetical. What if, (given current policy), the number of students with medical exemptions exceeds the threshold for maintaining herd immunity?

What should be done? Should they all be banished to the home schooling wasteland? Some of them? Who chooses? What principle is controlling?

Now, has Z. been “arguing” the “point”? No, instead he’s been piteously whining about the treatment his piercing “question(s)” have been receiving or, more accurately, that his imaginary blown-hair sword couldn’t cut butter.

Argus et al, I think zebra’s game actually is: you folks say kids with medical exemptions should be allowed to attend school (even in my fantasy scenario where there are enough medical exemptions to break herd immunity), so you not allowing ALL exemptions in the real world (where my scenario has approximately zero chance of actually happening for many reasons that I dismiss as irrelevant) makes you mean ol’ prejudiced poopyheads.

I’ve elided the details of your analysis because there’s never anything specific about his pathetic displays. It’s just the same moronic shіttrip over and over again.

Yes, the commentariat – which provides his sole source of interaction – are “prejudiced poopyheads.” Prejudiced against Z., that is. But the genuinely fυcked-up thing is that he seems to resent Orac for some reason.

I mean, for a while it just came off as “this is a stupid thing to write about!! But after a certain number of iterations, it’s just time to say go start your own fυcking blog if you’re so fυcking dissatisfied, asshοle.

^ Eh, blockquote fail. But anyway, who was the Burzynski crank? Even he was able to pull that off. Just imagine, Z. could bask in the glory of pingbacks as well, if he could only write something that approximated standing on its own.

Suppose there is a small community where everyone is related to everyone else and certain genetic traits are more common than elsewhere. In particular, in this community, ten percent of the population is unable to mount an immune defense against the measles. So on the first day of school, in the one public school that serves the community, the children (all vaccinated) are tested and it is determined that ten percent are not immune to the measles. What should the school do with these children since admitting them will bring the school below the herd immunity threshold?

The answer of all the minions is, “Admit them all to school and send them home if and when there is a measles outbreak that threatens them.”

“Aha!” cries zebra, “You would allow those non-immune children to attend, but you would not allow a similar number of children who were not immune because they were not immunized! Hypocrites! You demand immunization of those children with philosophical or religious exemptions as a punitive measure, not to preserve herd immunity!”

This response displays a misunderstanding of the whole debate.

Immunization is not a punitive measure. The hypothetical children who cannot mount an immune response are incapable of being protected from measles via vaccination. The children with philosophical or religious exemptions can be protected and the goal of more stringent requirements for exemptions is to encourage their parents to ensure that they are protected. In some cases, the parents will decide to home-school rather than get the children the protection available from vaccines, but in most cases they will not.

Bringing the exemption rate to a level that allows herd immunity is a second goal; it allows protecting those children who cannot be protected via vaccination. If in our hypothetical community that is impossible, well, it’s impossible. Hypothetical school policies must bow to the medical realities of the hypothetical community. But real world school policies can take into account real world medical realities, in which herd immunity is possible and should be sought after.

[…] doctor” spews antivaccine nonsense, when one of our state legislators tries to make vaccine exemptions easier to get, or when attempts are made to license naturopathic quackery. I particularly become outraged when a […]